Abstract
We assess the ability of health insurance plans with gatekeeping restrictions to control the utilization of medical care through their influence on the choice of the initial provider. Empirical results are based on the individual-level utilization panel data from 2001-2006 Medical Expenditure Panel Survey. We find only small differences between the initial provider chosen by individuals enrolled in gatekeeping and non-gatekeeping plans. This, together with the fact that within gatekeeping plans, 21 percent of patients self-refer to specialists, imply that the intended cost-containment effect of gatekeeping, namely restricting the utilization of specialty care, is surprisingly weak.
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