ABSTRACT
I. INTRODUCTION Since the beginning of the 1990s, medical health care reimbursements in the United States have evolved from a loosely controlled fee-for-service system into highly regulated managed-care organizations. Physicians, patients, employers, insurance companies, and local and federal government health agencies have a heightened awareness of increased health care costs and the driving forces behind them. This has resulted in the reexamination of recognized standard approaches for the diagnosis and management of many common medical disorders.
