Managed Care is simply a system that provides health care to a specific population purchased through health insurance plans. Practitioners and providers manage health service utilization and costs by providing effective diagnosis and treatment, appropriate use of inpatient and outpatient facilities, population-based planning, promotion and education. health and disease prevention. Managed care uses a “gatekeeper” system, in which patients or beneficiaries are assigned a primary care physician (PCP), whom they initially see for all medical care. The PCP acts as a gatekeeper, initiating referrals to specialists when necessary and approving inpatient admissions. Managed care was present in every American community as early as the 19th century, and by 1938 Henry Kaiser had adopted a prepaid medical plan for his employees. During World War II, Kaiser used prepaid medical plans for its workers and after the war it opened these plans to the public, which became the Kaiser Permanente we know today. Prepaid health care and health maintenance organizations (HMOs) came into full use in the 1970s when the federal government established grants and loans as part of a health care strategy to provide care for uninsured Americans by expanding the number of HMOs, increasing enrollment and containing the cost of health care. Since the 1970s, employers have used managed care as a form of high-quality, low-cost insurance for their employees and the federal government has turned to managed care for the Medicare and Medicaid programs. Managed care has become the primary source of health care delivery. Gaining popularity in the 1990s, managed care grew from 27% in 1988 to 99% in 2009 and fee-for-service plan enrollment declined...... middle of paper ...... system began implementing or planning a Medical Home resurgence, using a primary care physician and a team of health care professionals providing or facilitating health care to a group of patients (Meyer, 2009). Medical Home has been proven to save money for HMOs using this concept: Illinois Health Connect saved the state $140 million in 2009 by enrolling the state's Medicaid patients in the program (Japsen, 2010 ). Managed care needs to refocus on what made it successful in the beginning and use health care reform as a reason to move to the next phase of managed care, nursing homes. Will managed care survive? If the plans remain flexible, continue to provide quality service, and remain low cost, yes, but if they continue to become more like the antiquated insurance plans that they almost drove to extinction, then the answer is NO..