Reviews the changes managed health care has brought to the delivery and use of medical services and recommends specific steps that will make the existing system more responsive to the needs of children. Systemwide health care reforms must give children stable medical care that emphasizes preventive health and developmental services. (SLD)

Recently states have increasingly turned to managed care arrangements to finance and deliver health services to Medicaid beneficiaries. As this trend continues, states should carefully monitor changes in program costs and quality and implications for delivery of pediatric services and health outcomes for children. (SLD)