The stages of managed care regulation: Developing better rules

The managed care industry is at a crossroads. Belief in the ability of mark et forces alone to create an environment fostering quality health care at l ower cost is eroding. Regulators across the country are confronted with a g rowing consumer backlash against managed care. As a result, states have pas sed managed care reform legislation at unprecedented rates. In doing so, st ates are confronted with a patchwork of federal intervention and preemption . We examine the stages of these recent state and federal developments and evaluate them in terms of the traditional objectives of a reasonably functi oning health care system: quality care, access, and cost containment.