The morass of managed care: has it a place for advanced practice nursing?

A brief history of the development and growth of health maintenance organizations (HMOs) is presented; their differences from traditional medical practice and insurance are addressed. Critical management needs for success are discussed. Other entities in managed care are noted, especially how they differ from HMOs. How advanced nursing has been included in HMOs is presented. Future opportunities in HMOs are addressed, emphasizing differences among models. Finally, roles for nurses, not necessarily advanced practice nurses (APNs) in its strict meaning, who also need additional training and experience to perform duties other than direct patient care, are mentioned.