Managed care: past, present, and future.

The authors have examined managed care from several perspectives in this article. A look at the origins of managed care provided a historical perspective. The current state of managed care and its issues were presented. Finally, the authors speculated what the future may bring in terms of both continued current trends and significant changes in managed care. The authors hope that this presentation provides some insight to the practicing physician on how to work in a world with managed care and what the future may bring. Managed care brings changes in the way physicians practice, but it also offers physicians many opportunities to improve the quality and cost-effectiveness of health care. Managed care is the wave of the present and of the future. It is the health care market's choice to address the challenges that health care faces in quality, cost-effectiveness, accountability, access, and choice. Although there are numerous proposed, alternative, and theoretic solutions, managed care has insurmountable momentum. It will be molding the shape of health care as society enters the twenty-first century.