closed panel

(redirected from Gatekeeper Model)
A managed care plan—e.g., staff and group model HMO—in which covered insureds must select a primary care physician, who has control over referrals to other physicians in or out of the group. Closed panels generally do not reimburse their members for health care services used outside of the provider network

closed panel,

n 1. in a prepayment plan, a group of dental professionals sharing office facilities who provide stipulated services to an eligible group for a set premium. For beneficiaries of plans using closed panels, choice of dental professionals is limited to panel members. Dentists must accept any beneficiary as a patient.
2. a closed-panel dental benefits plan exists when patients eligible to receive benefits can receive them only if services are provided by dental professionals who have signed an agreement with the benefits plan to provide treatment to eligible patients. As a result of the dental professional reimbursement methods characteristic of a closed-panel plan, only a small percentage of practicing dental professionals in a given geographic area are typically contracted by the plan to provide dental services.
References in periodicals archive ?
China aims to build these new facilities in a fashion that also will establish a gatekeeper model in the rural areas.
The new framework the law sets up, which emphasizes prevention and wellness care, is a much better way to advance primary care, he said, as opposed to the gatekeeper model that was tried over a decade ago.
The new focus on prevention and wellness is a much better way to advance primary care, he said, compared with the gatekeeper model that was tried over a decade ago.
This study included a creative replication of extant theory and practice, at that time dominated by the gatekeeper model of two-step communication flow in R&D laboratories.
The gatekeeper model is inefficient for the delivery of dermatologic services.
The Gatekeeper model, which started in Spokane in 1978, is funded by state, federal and grant money Those wishing to become Gatekeepers must complete a training course in identifying and helping at-risk elderly people.
HMOs have developed from a tightly managed, gatekeeper model to less-restrictive models in recent years, following protests from consumers and physicians.
Proponents of the PCMH insist that it is not a gatekeeper model," the ACEP statement reads.
Patient demand for direct access to specialists is growing, which reflects the population's insatiable appetite for high-technology medicine and may also be indicative of a backlash against the gatekeeper model imposed by managed care.
HCO Select is a workers' compensation gatekeeper model featuring utilization management services and telephonic and field case management as well as prospective and concurrent medical management.
ATLANTA -- The primary care gatekeeper model in which physicians have financial incentives to minimize specialist referrals was associated with poorer quality of care in a large study of cardiovascular outcomes in diabetic patients, Dr.
A method favored by many managed care companies is to require beneficiaries to select a primary care provider, who is almost always a generalist (family practitioner, general internist, or pediatrician), to guide them through the health care system, the so-called gatekeeper model.