Human services at risk

Publicly supported social services in America are undergoing a major revolution. After the inception and growth of the welfare state came a pervasive switch to the delivery of services by private, mainly nonprofit organizations. Now comes what promises to be an equally pervasive switch from fee-for-service to managed care. This time, moreover, the dominance of nonprofit organizations in public social services is very much in question. The possibility that managed care might work out to the advantage of recipients is discussed, as is the possibility that it might not In the latter connection, a formula is advanced for containing "inappropriate" incentives.