To understand CareMore, the new managed care organization that's coming to town, you need to start at the feet, specifically, the patient's feet. The CareMore Health Plan was formed in 2003 in California by physicians who realized they were taking good care of their elder patients by looking at the big picture.

"They were looking at their diabetics and realized that they were controlling them so they weren't having amputations," said Joanne Steffen, executive director for the Nevada CareMore operation. "What they did was invite their patients to come in on a monthly basis to have their toenails clipped."