Managed care organizations that serve the poor face unique challenges. Not only must they empower their enrolled populations with awareness and knowledge about the benefits of being enrolled, but they must also provide significant outreach, offer services that are sensitive to urban and rural concerns, and stress health education and disease prevention. The managed care model offers efficiency and effectiveness that can place providers on the leading edge of not only providing solutions that address the needs of the underserved, but being competitive in servicing these populations.