The clear but qualified success of IPS-based supported employment invites further efforts to improve it and assess it against the most promising alternatives, which may include a clubhouse model. At least two directions for improvement are now under active investigation. One, highlighted by McGurk and Mueser (page 1406), is combining IPS services with cognitive remediation strategies. A second is to offset problems in access to and provision of high-quality psychiatric care, including medication management, which Cook (page 1391) notes may constitute barriers to employment. The Social Security Administration has recently funded a major trial, the Mental Health Treatment Study (www.ssa.gov/disabilityresearch/mentalhealth.htm), that will randomly assign SSDI recipients with mental disorders to IPS services combined with medication monitoring by using the protocols of the Texas Medication Algorithm Project. This study will also substantially expand financial coverage of behavioral health services for the experimental group. The results will be valuable in assessing the degree of synergy between improvement in access to and quality of care and IPS services.