In 1995–1997, David Blumenthal, MD, PhD, and researchers at Massachusetts General Hospital, Boston, evaluated the impact of a major component of managed care—the use of a primary care physician as a gatekeeper to authorize all health services of HMO members.
Researchers collected health care claims data from the two years before and the two years after patients switched from a traditional indemnity plan without gatekeepers to an HMO. Researchers also conducted self-administered surveys of both patients and physicians.
This project was part of the Robert Wood Johnson Foundation (RWJF) national program Changes in Health Care Financing and Organization (HCFO).
Researchers reported the following findings in a Findings Brief available at the HCFO website.