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Based on a five-year evaluation of an $80 million U.S. Army demonstration program, this first-of-its kind study explores the cost effectiveness of a managed care model of service delivery for children and adolescents with mental health and substance addiction problems. Contributions report on the quality, cost, and clinical outcome and raise critical questions about the effectiveness of mental health services and their delivery in community settings. Chapters describe new approaches to measurement and provide analyses assisting future research on managed care.