DENNIS P. ANDRULIS is director of the Office of Urban Populations at the New York Academy of Medicine. He is a contributing editor to the American Journal of Medicine and a founding board member of the American International Health Alliance, which creates health care partnerships with U.S. and Central and Eastern European providers of health care. He has published extensively on a broad range of health policy issues. Andrulis is former president and CEO of the National Public Health and Hospital Institute. BETSY CARRIER is vice president for managed care at the National Association of Public Hospitals & Health Systems and has worked in health care management for over 20 years. She has extensive experience in developing managed care plans and case management programs for individuals covered by both Medicaid and commercial insurance.