Managed care is coming to Medicaid mental health programs, with many states replacing a fee-for-service system with capitation. What is the impact of this change on mental health care? What special challenges do consumers, providers, and others face as a result? In this issue, the contributors examine the development of Oregon's bold approach to health care reform, providing valuable insights into the full range of issues that arise when states integrate mental health into a larger effort to provide health care for the uninsured. The contributors explore a full range of qualitative, quantitative and financial outcomes, offering insights into what is working, where improvement is needed, and what other states can learn from Oregon's experience. They address such areas as consumer involvement in shaping the mental health phase in of the plan, the impact of the plan on minorities, the financial results for mental health care contractors, and more. This is the 85th issue of the quarterly journal New Directions for Mental Health Services.