Medicaid is the primary means for providing medical care to the nation's indigent and disabled populations. Almost 13 percent of all Americans received some form of medical coverage, such as physician services or long-term care, through Medicaid in the early 1990s. The costs continue to rise dramatically, and state governments have become alarmed by the growing share of their budgets that Medicaid consumes.

Daniels and his contributors present the efforts of 16 states to reform their Medicaid programs through a system of managed care--programs that seek to control or manage the use by...