Managed care, health care reform, and the role of providers of aging services. Devolution threatens the safety-net role played by the federal government.

Managed care which emphasizes the rationalization of the way health care is financed, the devolution movement which shifts greater program responsibility to the state and local levels, and the restructuring of Medicaid along the lines of a block grant program, are issues presenting providers of aging services with a daunting set of challenges and opportunities. Providers of aging services will need to build on existing strengths, while developing new strategies, to succeed under an environment of managed care and state and local funding control.