Question: In what year were the pioneers of managed care in the United States established?

full_context: Document 1: Group O: Group O, Headquartered in Milan, Illinois, is one of the largest Hispanic-owned companies in the U.S. and a provider of managed products and services, specializing in Marketing Services, Print Management, Business Analytics, Decision Sciences, Business Process Outsourcing, Managed Services, Packaging, Supply Chain and Third-Party Logistics (3PL). Founded in 1974, Group O has grown to approximately 1,500 employees across 34 U.S. facilities. The company targets a broad range of industries, including: food and beverage, telecommunications, manufacturing, consumer packaged goods, financial services, pharmaceutical, health care, retail and technology. The company’s major clients include AT&T, Bristol-Myers Squibb, Caterpillar, Frito-Lay, Kraft Foods, Microsoft, PepsiCo, and Staples.
Document 2: Kaiser Permanente: Kaiser Permanente ( ; KP) is an integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser Permanente is made up of three distinct but interdependent groups of entities: the Kaiser Foundation Health Plan, Inc. (KFHP) and its regional operating subsidiaries; Kaiser Foundation Hospitals; and the regional Permanente Medical Groups. As of 2014, Kaiser Permanente operates in eight states and the District of Columbia, and is the largest managed care organization in the United States.
Document 3: MedStar Georgetown University Hospital: MedStar Georgetown University Hospital is one of the national capital area's oldest academic teaching hospitals. It is a not-for-profit, acute care teaching and research facility located in the Georgetown neighborhood of the Northwest Quadrant of Washington, D.C. MedStar Georgetown is co-located with the Georgetown University Medical Center and is affiliated with the Georgetown University School of Medicine. Its clinical services represent one of the largest, most geographically diverse, and fully integrated healthcare and delivery networks in the area. MedStar Georgetown is home to the internationally known Lombardi Comprehensive Cancer Center, as well as centers of excellence in the neurology, neurosurgery, psychiatry, gastroenterology, transplant and vascular surgery. Originally named Georgetown University Hospital, it became part of the MedStar Health network in 2000.
Document 4: Group Health Cooperative: Group Health Cooperative, (formerly known as Group Health Cooperative of Puget Sound), later more commonly known as Group Health, was a Seattle, Washington based nonprofit healthcare organization. Established in 1945, it provided coverage and care for about 600,000 people in Washington and Idaho and was one of the largest private employers in Washington.
Document 5: Georgetown University Medical Center: Georgetown University Medical Center (GUMC) is the medical campus at Georgetown University. It is also a $225 million biomedical research and educational organization. The Medical Center contains over 80% of Georgetown University's sponsored research funding and is led by Edward B. Healton, MD, the Executive Vice President for Health Sciences and Executive Dean of the School of Medicine
Document 6: George Washington University Hospital: The George Washington University Hospital is located in Washington, D.C. in the United States. It is affiliated with the George Washington University School of Medicine and Health Sciences. The current facility opened on August 23, 2002, with 371 beds in a 400,000 sq. ft. building, housing more than $45 million of medical equipment and costing over $96 million to construct. The hospital is licensed by the District of Columbia Department of Consumer and Regulatory Affairs and accredited by the U.S. Joint Commission.
Document 7: University of Washington: The University of Washington (commonly referred to as UW, simply Washington, or informally "U-Dub") is a large, public flagship research university in Seattle, Washington, established in 1861.
Document 8: Tufts University School of Medicine: The Tufts University School of Medicine is one of the eight schools that constitute Tufts University. The "Times Higher Education (THE)" and the "Academic Ranking of World Universities (ARWU)" consistently rank Tufts among the world's best medical research institutions for clinical medicine. Located on the university's health sciences campus in downtown Boston, Massachusetts, the medical school has clinical affiliations with thousands of doctors and researchers in the United States and around the world, as well as at its affiliated hospitals in both Massachusetts (including Tufts Medical Center, St. Elizabeth's Medical Center, Lahey Hospital and Medical Center and Baystate Medical Center), and Maine (Maine Medical Center). According to Thomson Reuters' "Science Watch", Tufts University School of Medicine's research impact rates sixth among U.S medical schools for its overall medical research and within the top 5 for specialized research areas such as chronic obstructive pulmonary disorder, urology, cholera, public health & health care science, and pediatrics. In addition, Tufts University School of Medicine is ranked 44th in research and 38th in primary care according to "U.S. News & World Report".
Document 9: University of Pittsburgh Medical Center: The University of Pittsburgh Medical Center (UPMC) is a $16 billion integrated global nonprofit health enterprise that has 80,000 employees, over 30 hospitals with more than 8,000 licensed beds, 600 clinical locations including outpatient sites and doctors’ offices, a 3.2 million-member health insurance division, as well as commercial and international ventures. is closely affiliated with its academic partner, the University of Pittsburgh. It is considered a leading American health care provider, as its flagship facilities have ranked in "US News & World Report" "Honor Roll" of the approximately 15 to 20 best hospitals in America for over 15 years. As of 2016, UPMC is ranked 12th nationally among the best hospitals (and second in Pennsylvania) by "US News & World Report" and ranked in 15 of 16 specialty areas when including Magee-Womens Hospital of UPMC. This does not include Children's Hospital of Pittsburgh of UPMC which ranked in the top 10 of pediatric centers in a separate "US News" ranking.
Document 10: Allied Arts of Seattle: Allied Arts of Seattle is a non-profit organization in Seattle, Washington, USA. The organization advocates for public funding of the arts, better urban planning and architecture, and other civic improvements. The organization claims to be the "oldest non-profit organization in Seattle dedicated to urban livability", but, in any case, at 50+ years old is certainly a venerable organization by the standards of a city barely older than 150 years It was a major force in establishing the Seattle Arts Commission, creating Seattle Center on the grounds of the Century 21 Exposition (1962 world's fair) and preserving historical landmarks and neighborhoods, particularly Pioneer Square and Pike Place Market, as well as defeating the 2012 Seattle Olympic bid.
Document 11: Medical facilities of Seattle: This is the main article on the medical facilities of Seattle, Washington. Seattle, USA is well served medically. The University of Washington is consistently ranked among the country's dozen leading institutions in medical research; Group Health Cooperative was one of the pioneers of managed care in the United States; and Seattle was a pioneer in the development of modern paramedic services with the establishment of Medic One in 1970.
Document 12: The Co-operative Group: The Co-operative Group, trading as The Co-op, is a British consumer co-operative with a diverse family of retail businesses including food retail; electrical retail; financial services; insurance services; legal services and funeralcare, with in excess of 4,200 locations. It is the largest consumer co-operative in the UK and owned by more than 4 million active members. Membership is open to everyone aged 16 and over in the society, provided they agree to subscribe £1 sterling in the capital of the society out of their first share of the profits and share the values & principles upon which the group was founded. Members are democratically involved in setting business strategy, decide how social goals are achieved, and share in its profits - in the 2016 £19m was returned to members and their chosen local community causes via the 5+1 scheme. No year end dividend was paid in 2015.
Document 13: Health maintenance organization: In the United States a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status.
Document 14: University of Washington station: University of Washington is a light rail station in Seattle, Washington, located on the University of Washington campus. The station is served by Sound Transit's Link light rail system and is the terminus of the Central Link line, which continues south towards Capitol Hill station and Downtown Seattle. University of Washington station is located at the intersection of Montlake Boulevard Northeast and Northeast Pacific Street, adjacent to Husky Stadium and the University of Washington Medical Center
Document 15: Medical Faculty Associates: The George Washington University Medical Faculty Associates is a non-profit 501(c)3 physician group practice affiliated with the George Washington University. The MFA group practice is made up of academic clinical faculty of the GW Medical School. As of 2015, the group had more than 750 physicians providing medical services to the Washington DC, Northern Virginia, and Maryland areas. The GW Medical Faculty Associates offers over 51 specialty areas of care. The organization is a partner with the George Washington University Hospital and the School of Medicine and Health Sciences.
ground_truth: 1945