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Mar 17, - During the s and 90s, increased enrollment in private sector managed care in the United States was spurred by the ability of this approach.

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the dominant form of health insurance in the private sector (Glied ). Hospital concentration and HMO penetration share a common, upward trend.

In addition to HMO enrollment, over thirty-eight million individuals were eligible .. has the highest managed care market penetration of any state, private-sector.

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