Who coordinates patient care under HMO plans and is also known as a gatekeeper?

The primary care physician (PCP) acts as a gatekeeper in Health Maintenance Organization (HMO) plans by coordinating all aspects of patient care. This role is crucial because the PCP typically serves as the first point of contact for patients seeking medical attention. They are responsible for managing and directing patients’ care, deciding when referrals to specialists are necessary, and ensuring that patients receive appropriate preventive services and follow-ups.

In an HMO structure, where care is often confined to a network of providers, the PCP's function is to guide patient access to healthcare resources. By doing this, they not only help in controlling healthcare costs but also streamline the treatment process for patients, promoting a cohesive approach to their health management.

In contrast, other roles such as health services managers, nurse practitioners, and insurance case managers, while involved in various aspects of healthcare, do not fulfill the same coordinating function in the patient-care continuum within HMO plans, as their focus may differ—ranging from administrative management to specific clinical duties.