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The rapid growth of managed care has made it harder for many Americans to receive medical help from some of the leading U.S. teaching hospitals. Managed care plans bargaining for the best hospital rates often exclude the top-rated ones. Joining forces against this inexorable economic trend, thirteen leading U.S. cancer centers today announced the formation of an alliance called the National Comprehensive Cancer Network, which will conduct joint research and will attempt to enhance patient access to the latest cancer treatments. "Managed care is not anti-quality," says Dr. George Demitri, Chief of Clinical Services for the Dana-Farber Cancer Institute, which formed the alliance along with Johns Hopkins, Memorial Sloan-Kettering, the Stanford University Medical Center and other institutes. But Demitri adds that the control over patient access to certain hospitals that is wielded by managed care plans amounts to the power to define the quality of care: "We hope that this gives us a new way of working with managed care."