Teach HMO patients what to expect

Many physicians and groups are thriving with managed care and capitated practice by communicating with their patients from the start of the relationship. They form their patients' expectations, telling them what to expect, what they can and cannot do in seeking treatment, and generally how the system works.

Start the process by sending a welcome letter as soon as you receive a new patient's name. The letter serves as your first description of your arrangements for care, including your triage through a nurse, routine care through qualified extenders and nurses, and (if primary care) your gatekeeper duty for calls to specialists.

When the new patient first visits your office, be sure a staff member adds to the training process. It's a natural opportunity to explain preauthorization, what is and is not an emergency, and how phone calls may help reduce the need for in-person care.