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Keywords:

  • HMO;
  • managed care;
  • transaction costs;
  • Williamson

Abstract

After an historical review of the advent of managed care in the USA, this article presents cost-control mechanisms, changes in the medical practice and consequences on patient health. The article also explains the development of the HMO using the transaction costs theory and the subsequent orientations of the US health care system. Copyright © 2005 John Wiley & Sons, Ltd.