Abstract
Across the nation, states are placing their faith in managed care as the solution to the rising health care costs associated with the Medicaid program. Historical providers of care to the vulnerable and uninsured are competing in this new price-sensitive market while struggling to remain faithful to their missions. In Maryland, a unique partnership between an academic health center (Johns Hopkins HealthCare) and a coalition of community health centers has emerged as a model that promises to preserve the financial and philosophical goals of historical providers.