Managed care organizations and their products will continue to change in response to consumer demands, competitive pressures, and regulatory requirements. Providers who gain an understanding of the world managed care organizations live in can also expect to influence these organizations for mutual benefit. Just as managed care organizations differ in the sophistication of their functional elements, providers and their organizations differ in their ability to shift their focus from the physician-patient relationship to improving the health of a population. As the future of managed care evolves, there are opportunities for those physicians who strive for a greater understanding of the broad spectrum of forces shaping the health care industry.