Abstract
Medicaid managed care is becoming prevalent throughout the United States, but some commercial HMOs are exiting from the Medicaid market. This phenomenon suggests that success in this relatively new market depends on the development of Medicaid HMOs around the key safety-net providers in the community. These essential providers offer the backbone of expertise and commitment needed to serve the Medicaid population while they are eligible for coverage as well as after their Medicaid eligibility ends.