However, although blended funding is effective, it is difficult to accomplish. Sites have found that purchase of service arrangements can accomplish the same goal as blended funding. A reinvestment strategy can convince those who control the budget for human services to reinvest other resources in the site. Managed care can be a pro-active strategy for sustainability or a reactive strategy. Managed care represents an approach for ensuring accountability in service delivery and the issue for sites, is how managed care is implemented and their role in delivering services through the managed care system.
Several sites demonstrate that managed care can redirect resources.
Sites that have dealt most successfully with Medicaid managed care are those where the public system has organized the managed care approach. The importance of presenting good data to policymakers cannot be overemphasized. Policymakers need reliable data that points to a clear conclusion of effectiveness of services and cost-effectiveness of the system. Data should be relevant to current political concerns, such as child welfare placement rates, school drop-outs, rising juvenile justice facility populations and easily understood and supported by concrete examples of child and family experiences. Sophisticated communications and media work are essential for any organization seeking to become an effective agent for social change.