The PCP's Increasingly Important Role

An individual's primary care physician (PCP) serves as their first point of entry into healthcare. PCPs conduct routine check ups, preventative care, and are often the first healthcare providers that patients voice any concerns to. As such, a strong patient-physician relationship is very important to ensure a high standard of healthcare, but is especially cruciual for Health Maintenance Organization (HMO) health insurance plans. Many HMO plans have PCPs serve as a gatekeeper, requiring them to approve any additional testing or appointments with specialists. HMOs also often have a more limited network of doctors and hospitals you can visit, making it more difficult to find a physician based on word-of-mouth references.

If patients are unable to properly communicate with their physician or trust them enough to discuss their concerns and needs, the gatekeeper model can be incredibly harmful; it can encourage patients to delay care and allow their issue to grow, or PCPs may not have a clear understanding of the problem and suggest an incorrect sequence of steps.

As HMO plans become more common due to their cost-saving pricing structure, Caralyst's patient-physician matching tool will allow insurers to maximize their benefits and incentivize patients to join their plan by ensuring that they will have the opportunity to find a physician that understands them and is trustworthy.

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