Managed care is a health care delivery system in which costs, accessibility, quality, and outcomes of care across a continuum of health services are tightly regulated with various rules, guidelines, and oversight methods. Elements of managed care are cost-containment measures; access and use control; standards of care, outcome assessment, and continuous quality improvement; provider and patient education; and management information systems. Cost-containment measures involve the identification of behaviors and activities that generate unnecessary costs and the implementation of corrective policies and measures. Although inmates should have ready access to health care, how and when health services are used must be controlled. Also, the facility should be evaluated in terms of standards of care, outcome assessment, and continuous quality improvement. Staff and providers should be given training courses and seminars designed to increase clinical skills, the elimination of certain tests and other unnecessary procedures, the avoidance of repetition, reduction in liability risks, and ways to increase productivity and contain costs. Another key element in managed care is an efficient, automated management information system. 6 references