Managed competition is a concept that was born in California and has achieved a measure of acceptance there. As California and the United States as a whole continue to struggle with the challenge of providing high-quality health care at a manageable cost, it is worth asking whether managed competition—with its tools for harnessing market forces—continues to hold promise as a means of improving value in health care, and whether the standard conceptualization of managed competition should be modified in any way.

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