Health care delivery has experienced unprecedented changes during the past decade due to advances in medical technology, new generations of pharmaceuticals, and a shift toward preventive measures and managed care. At the same time, the prevalence of serious diseases such as HIV infection and drug-resistant tuberculosis has increased dramatically. In the correctional health care environment, the ACA has endorsed performance-based standards. These standards require the analysis of outcome measures, distinct from program activities. The ACA also indicates standards for correctional health care programs will soon be available to correctional agencies desiring a stand-alone accreditation of their health care programs or a specialized accreditation to complement the ACA's facility-wide accreditation award. 1 table