Questions: In most HMOs, a person in unable to see a specialist without being referred by the primary care physician. True False

The answer is True.

In most Health Maintenance Organizations (HMOs), the healthcare model is designed to control costs and manage care through a network of providers. A key feature of HMOs is the requirement for members to select a primary care physician (PCP). The PCP acts as a gatekeeper for the patient's healthcare needs.

• In this model, the primary care physician is responsible for providing general healthcare services and coordinating any necessary specialist care. If a patient needs to see a specialist, they must first obtain a referral from their PCP. This process helps ensure that specialist services are used appropriately and that the patient's care is well-coordinated.

• This option would imply that patients can directly access specialists without a referral, which is not typically the case in most HMOs. Direct access to specialists without a referral is more common in Preferred Provider Organizations (PPOs) or other types of health plans that offer more flexibility in choosing healthcare providers.