Managed care arrangements: barriers to cost savings potential.

Between 1980 and 1991, national health spending increased from $250 billion to $752 billion a year (1993 Data Compendium 1993). This figure is projected to increase to $1.1 trillion by 1995, and $1.7 trillion by 2000 (Burner, Waldo, and McKusick 1992). As both public and private payers of health care continue to be stymied by the uncontrollable inflationary spiral, pressure on the federal government to reform