ABSTRACT
Managed care has seen dramatic growth as a key element of the health systems in many countries. The result has been new forms of managed care organizations (MCO) as well as differing means for managing those providers to ensure the provision of high-quality care in a cost-effective manner. The trend is particularly pronounced in the US, where this organizational form has grown to cover over 50 percent of the population in some areas such as Massachusetts. The challenge for MCOs and the US health system for the future will be to regain public confidence and be able to demonstrate the positive effect of MCOs on quality, while limiting the freedom of choice of providers enough to allow for maintaining control of health care costs. MCOs are therefore unique because they combine the perspectives of the three main actors: providers, insurers, and members.
