HMO medicine sets up an inevitable conflict between the physicians' traditional fiduciary role and the financial interests of the health plan and its physicians. Regulatory interventions, such as the formulation of rules regarding clinical practice, put government in a micromanagement role it...

Institutional context plays a substantive role in ethical analysis. Accordingly, efforts to apply the principles of bioethics generally and without regard for institutional context may prove difficult. This article first addresses the aspects of two non-hospital settings - the managed care...

On the heels of widespread patient protection legislation in the states, the managed care industry abandoned or greatly scale back the core elements of gatekeeping, utilization management, and financial incentives, which are the very targets of this legislation. This article explores whether,...

The growth of managed care has prompted numerous questions about its impact on the quality of health care. This paper reviews evidence on the impacts of managed care on quality. Most comparisons of care for patients in different plans within similar markets suggests that there is little...