Health and Life Insurance

Answer: D - Being expensive to operate is not a reason for open access HMOs. Open access HMOs allow members to eliminate the primary care physician’s referral to receive care from network specialists. Although the services must still be provided by a network specialist within the HMO network, open access eliminates the need for the extra visit or phone call prior to scheduling an appointment. The open access HMO came from issues with delays in receiving the care needed, dissatisfaction with the gatekeeper system for referrals, and problems in obtaining referrals.