The HMO Spells it all out!

“Decreasing accessibility to services . . . . can be accomplished by “managing” the information distributed to patients regarding services available and how to access them.

For example, an organization might excessively promote less-costly preventive procedures . . . .and repress information about other elective and/or expensive services.

In addition, providers can strategically locate and number specific services to make them easy (e.g., primary care) or difficult (e.g., specialists) to utilize.

Furthermore, lag periods . . . . also serve as containment strategies. Lags may be affected by the need for referrals, limited number of contracted specialists, restricted or inconvenient appointment availability, and increased office-visit waiting periods.”

Borkowski NM.
Demarketing of health services.
Journal of Health Care Marketing 1994;14:12.