How have health plans changed in the past quarter century?
During the past two decades there's been an enormous growth in various types of managed care plans that direct the insured toward preferred providers. In 1990, nearly three work place plans in four (74%) were of the fee-for-service variety that reimbursed nearly any provider. This segment declined to 9% by 2000. In this same period health maintenance organizations grew from 16% to 39% of the market while preferred provider organizations, which are less tightly restricted than HMOs, grew from 11% to 52%.