A lively learning agenda.

It started with little, but telling, incidents. Like the time a utility company employee phoned the hospital to inquire about its cardiac package. Someone in the admitting office told him: "I'm not aware of any such plan, sir. By the way, what is a PPO anyway?" Then, about three years ago, an internal survey on managed care education confirmed an organization-wide knowledge gap in this area: Only 4 percent of directors and 7 percent of executives claimed to have a clear understanding of managed care. These were among the wake-up calls that became the impetus for a comprehensive education program at Borgess Medical Center, a 426-bed regional referral center in Kalamazoo, Michigan.