This text focuses on the impact of managed care on the health care delivery system and its effect on nursing. It guides students through the maze of the managed care environment with four major themes: The Health Care Environment: What It Is and How It Is Affected by Managed Care, Managed Care: What It Is and How It Works, Issues Affecting the Results of Managed Care, Managed Care: Implications for the Nurse. The text covers a wide variety of topics related to health care organizations, reimbursement, quality care, legal and ethical issues, changes in roles and responsibilities, tools and strategies used to monitor care, and changes in clinical practice. It incorporates the most recent information available to prepare nurses for practice in the 21st century.