Increasing healthcare expenditures and other economic pressures mandate fundamental reforms of the healthcare system in Germany. The overall goal is restraint of costs while at the same time maintaining a high standard of medical care. Among all options, managed care represents a potential solution, since it combines financing mechanisms and a care delivery system under the control and direction of a single management entity. A core element of managed care is cost containment through structured guidance of healthcare providers and patients. This has the potential to provide a higher level of control and promote greater transparency in the healthcare system. However, it remains to be seen if it is possible to adapt elements of managed care from other countries to the German healthcare system.