How does an HMO typically manage specialist referrals?

An HMO, or Health Maintenance Organization, typically requires referrals from primary care physicians for patients to see specialists. This structure is designed to ensure that patients receive coordinated and appropriate care. The primary care physician acts as a gatekeeper, assessing the patient's needs and determining whether a referral to a specialist is necessary. This management process helps in controlling healthcare costs and minimizing unnecessary specialist visits while ensuring that patients receive the right care at the right time. By requiring referrals, HMOs facilitate better communication between the primary care physician and specialists, which can lead to improved outcomes and streamlined care for patients.