>Insurance gates these but could do so with their own tech rather than relying on the third party. Could help with keeping loss ratios at the minimum.

I work in insurance. In my experience, the fact that you have to go to the doctor for a referral discourages people from getting said referral.

So the tradeoff is that you would get fewer referral-specific visits (i.e. person going to their GP to get a specialist referral) at the likely expense of more specialist visits.