ActivHealthCare, Inc. was established by the Georgia Chiropractic Association in 1993 as a provider sponsored managed care organization with the objective to provide chiropractors with a "voice" in the managed care arena. In 2006, the network expanded to include North Carolina, South Carolina, and Tennessee through a subsidiary, Integrated-ActivHealthCare, LLC. With more than 1,100 member providers strategically located across four states, ActivHealthCare has contracted with numerous networks throughout the Southeast. These networks are often referred to as managed care organizations ("MCOs"), preferred provider organizations ("PPOs") or health maintenance organizations ("HMOs").