Many Americans hold strong opinions about managed care. Audiences in movie houses across the nation famously broke into cheers when actress Helen Hunt's character cursed it in the 1997 movie As Good as It Gets. Managed care is an important element of the health care delivery system in the United States to day, and familiarity with it is aprerequisite to understanding the contemporary health care context. However, managed care is not neatly defined. Instead, it is an umbrella term covering a historically changing collection of administrative practices, organizational forms, and business strategies intended to make provision of health care more efficient.

Defining efficiency in this context has posed challenges. Some efficiencies focus on information, including electronic medical records, and profiling provider quality to facilitate informed choice ...

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