PIP: Although family planning and reproductive health care are essential services affecting the status of population health, much needs to be done in order to integrate them within the managed care framework. Obstacles in some managed care settings which may impede the establishment and provision of effective family planning and reproductive health services include the lack of sufficient time for education and behavior-changing professional intervention, the lack of barrier-free access to caregivers with the knowledge and skills necessary to provide comprehensive family planning and reproductive health care, and the need to ensure patient confidentiality. Many essential public health services share these problems. Another problem for many preventive investments is the short time horizon in which any single managed care provider can expect to realize a return on investment. Encouraging examples of change are, nonetheless, well underway in the managed care sector. The author notes that essential public health issues, especially family planning and reproductive health, have not received the emphasis they deserve in medical schools and specialty training curricula. Managed care organizations therefore need to compensate for this problem and provide additional training for existing primary care providers and health personnel. Already trained personnel can also be brought into the organization.