Which is a commonly cited drawback of managed care in terms of access?

Which is a commonly cited drawback of managed care in terms of access?

• A. Restricts provider/patient choice and access flexibility
• B. Increases patient choice across all providers
• C. Eliminates prior authorization requirements
• D. Increases out-of-network coverage without limits

Answer: (A)

Access is often limited by network and gatekeeping practices in managed care. Plans define a network of preferred providers, and staying within that network usually yields full benefits. That means patients have fewer choices of where to go and how quickly they can access services, since out-of-network care is limited, more costly, or not covered except in emergencies. Referrals and prior authorizations can also slow or restrict access to certain treatments or specialists, further reducing how freely patients can obtain care. Other options don’t fit because they imply more freedom to choose providers or fewer administrative steps, which isn’t characteristic of typical managed care models.

Access is often limited by network and gatekeeping practices in managed care. Plans define a network of preferred providers, and staying within that network usually yields full benefits. That means patients have fewer choices of where to go and how quickly they can access services, since out-of-network care is limited, more costly, or not covered except in emergencies. Referrals and prior authorizations can also slow or restrict access to certain treatments or specialists, further reducing how freely patients can obtain care.

Other options don’t fit because they imply more freedom to choose providers or fewer administrative steps, which isn’t characteristic of typical managed care models.