Approximately one-quarter of the U.S. population is enrolled in HMOs or similar managed care health plans, and the proportion is increasing. But even though such plans dominate today's agenda for health care reform, good, quantitative information on the performance of managed care programs is scarce. In Promise and Performance in Managed Care, Donald Freeborn and Clyde Pope draw on the research literature and unique data sources to provide that information.

Focusing on the human experience of managed care, the authors examine the effects of managed care on members as well as physicians—assessing whether members are satisfied with the care they receive, and how physicians evaluate their experience with managed care. After offering a brief history of managed care in the United States, the book addresses such questions as what determines the choice of a health plan, access to care, patient satisfaction, physician satisfaction, and the implications of these findings for the future of managed care.

With the issue of health care reform in the forefront of national debate, the topics raised in Promise and Performance in Managed Care are particularly timely. Serving as both a standard against which to examine the effectiveness of proposed reforms and as a methodological "how to" for the evaluation of system changes, the book will be of interest to professionals and students of health policy as well as to HMO administrators and practitioners.

Donald K. Freeborn is a senior investigator at the Kaiser Permanente Center for Health Research in Portland, Oregon. Clyde R. Pope is the associate director of the Kaiser Permanente Center for Health Research. Both are adjunct professors of sociology at Portland State University and hold adjunct appointments at the Oregon Health Sciences University.