In the 1970s, a group of physicians planned the first managed care contract. It was sold on the basis using a Bell-shaped curve, the right half was unnecessary spending. They sold this to hospitals and some physician groups that they could eliminated the right half of the curve in their managed care scheme. They would review charts, obtain dschg planning, get the patients dschg ASAP and save maybe 40% of the health care costs and with their 20% fee, health care costs would certainly decline.

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