Key elements in providing basic health care to men, women, and juveniles incarcerated in jails and detention centers include recognizing the changing face of the inmate population, using creative and innovative strategies, taking advantage of high technology available in the health care industry, and relying on managed care principles. Jail health care providers must deal with such problems as drug abuse and addiction, tuberculosis, chronic diseases, mental illness, and HIV and will need to address the health care needs of older offenders. Creative and innovative strategies are needed that have the support of both medical and custodial staff. Correctional officials must continue to assume a leadership role in demonstrating effective ways to manage limited resources, and the use of managed care principles will help in this regard.