Before taking responsibility for a population's care, it is vital to have data on previous use and costs as well as demographic data. The authors had data for the previous two years for 7,500 of their 22,000 patients, although it is not clear whether they obtained data for the entire population from the organization that previously held the contract. Thus it is hard to accept on faith that the data for 1998 to 2000 demonstrate improved management. Also, the authors acknowledge that two years is not long enough to determine whether the decreases in service use and cost were due to skill or to luck. Finally, despite the large positive differences between income and expenses under this contract, the department and MSC each made only $18,000 the first year and $29,000 the second. It is important to know whether the contract brought other advantages.