Managed Care Organizations (MCO) are among the healthcare providers that distribute medical services to people by giving them managed healthcare plans and packages ( Calavita, 2020) . The American managed care organization is believed to have started in the 19 th century. During that time, only a few medical practitioners in some cities were capable of establishing an initiative that offered members with prepaid services of trade unions or fraternal orders, among many other services.

At the beginning of the twentieth century, people who worked in lumber companies, railroad s, and mining sites, which were the most honored occupations in that period , hired their own physicians for medical services , which they paid with a certain fee every month ( Carson, 2016 ) . However, during the 1930s recession, there were a variety of prepaid contracts between employees and their employers, an action intended to guarantee their salary. As a result, a large number of employees in that period decided to contract managed care packages, whose pa y would be made in lumpsum.