Managed care--present day challenges and a working model for future consideration

With the emergence of managed care as a dominant form of coverage for the American workforce and the concomitant growth in the number of uninsured and underinsured citizens, attention is increasingly focused on the development of cost-effective and efficient reimbursement strategies for the future. This manuscript provides both a summation of the different forms of coverage now available and a look at a possible future scenario through the only universal health insurance program now in place in the United States--Hawaii's health care system.