The review identifies major sources of health care expenditures documented in current Correctional Medical Services (CMS) and sheriff's department budgets; identifies hidden medical costs; recommends ways to achieve greater cost efficiency in health care delivery; and promotes quality health care within the current range of expenditure. Data were collected through an analysis of budgetary documents, interviews with key employees and managers of CMS as well as medical liaisons from the sheriff's office, site visits to jails, and inmate interviews. The report discusses CMS administration and organization, correctional health care expenditures, and third-party reimbursements. Variables of current health care delivery examined here include intake and screening process, tuberculosis screening and treatment, sick calls, infirmary units, pharmacy service, hospital admissions and discharges, and continuity of care. 6 tables, 12 notes, and 1 appendix