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Primary care has often been termed the de facto mental health system in the United States. [7] Research shows that approximately half of all mental health care services are provided solely by primary care providers. [8] Furthermore, primary care practitioners prescribe about 70% of all psychotropic medications and 80% of antidepressants. [9]
The typical IPA encompasses all specialties, but an IPA can be solely for primary care, could be single specialty, or could be a set of other care providers such as psychologists or even providers of social services such as food pantries, homeless shelters, or substance use disorder treatment facilities. [2] [3]
Unlike PPOs, however, HMOs often require members to select a primary care physician (PCP), a doctor who acts as a gatekeeper to direct access to non-emergency medical services, and are required to first obtain a referral from their PCP in order to be reimbursed for the cost of medical services inside of their network of designated doctors and ...
HMOs often require members to select a primary care physician (PCP), a doctor who acts as a gatekeeper to direct access to medical services but this is not always the case. PCPs are usually internists, pediatricians, family doctors, geriatricians, or general practitioners (GPs). Except in medical emergency situations, patients need a referral ...
Enrollees in a POS plan are required to choose a primary care physician (PCP) from within the health care network; this PCP becomes their "point of service". The PCP may make referrals outside the network, but with lesser compensation offered by the patient's health insurance company.
In the design of the plan, each member is assigned a "gatekeeper", a primary care physician (PCP) responsible for the overall care of members assigned. Specialty services require a specific referral from the PCP to the specialist. Non-emergency hospital admissions also require specific pre-authorization by the PCP.
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