Foreword
A growing number of Americans (more than 160 million in 1997)are insured through managed care health plans. These plans attemptto control the cost and quality of health care by coordinatingthe use of services by enrolled members. Managed care plans acceptfinancial responsibility for a set of benefits in return for apremium paid for by, or on behalf of, the member.While the shift to managed care and away from the traditionalfee-for-service system has been effective in containing healthcare costs, there is widespread concern that consumers have beenleft without recourse when they are improperly denied needed careby their health plans.A 1998 report by…
