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

<P0-S0> This is the main article on the medical facilities of Seattle, Washington. <P0-S1>  Seattle, USA is well served medically. <P0-S2>  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. <SEP> <P1-S0>  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. <P1-S1> 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. <SEP> <P2-S0> Abrazo Community Health Network (Abrazo Health) is one of the largest health care delivery system in Arizona, United States. <P2-S1>  Abrazo Community Health Network is located in Phoenix, Arizona and was established in 2003. <P2-S2>  The Abrazo system comprises six acute care hospitals including one cardiovascular-specialty hospital. <P2-S3>  The health care system offers a broad range of medical services, including cardiology, internal medicine, general surgery, orthopedics, neurology, obstetrics, bariatrics, women’s health, diagnostic imaging, outpatient services, and emergency care. <P2-S4>  In addition to the hospitals, Abrazo Community Health Network includes primary and specialty care physician offices, urgent care offices, emergency centers and managed care health plans (under the name Phoenix Health Plans). <SEP> <P3-S0> Aetna Health Inc. v. Davila, 542 U.S. 200 (2004) , was a United States Supreme Court case in which the Court limited the scope of the Texas Healthcare Liability Act (THCLA). <P3-S1>  The effective result of this decision was that the THCLA, which held Case Management and Utilization Review decisions by Managed Care entities like CIGNA and Aetna to a legal duty of care according to the laws of The State of Texas could not be enforced in the case of Health Benefit plans provided through private employers, because the Texas statute allowed compensatory or punitive damages to redress losses or deter future transgressions, which were not available under ERISA § 1132. <P3-S2>  The ruling still allows the State of Texas to enforce the THCLA in the case of Government-sponsored (Medicare, Medicaid, Federal, State, Municipal Employee, etc., Church-sponsored, or Individual Health Plan Policies (High-deductible individual policies, self-pay, any insurance not subsidised by a Private Employer), which are saved from preemption by ERISA. <P3-S3>  The history that allows these Private and Self-Pay Insurance to be saved dates to the "Interstate Commerce" power that was given the federal Government by the Supreme Court. <P3-S4>  ERISA, enacted in 1974, relied on the "Interstate Commerce" rule to allow federal jurisdiction over private employers, based on the need of private employers to follow a single set of paperwork and rules for pensions and other employee benefit plans where employers had employees in multiple states. <P3-S5>  Except for private employer plans, insurance can be regulated by the individual states, and Managed Care entities making medical decisions can be held accountable for those decisions if negligence is involved, as allowed by the Texas Healthcare Liability Act.