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This process evaluation of the development of strategic alliances between area agencies on aging (AAAs) and managed care organizations (MCOs) identified factors that facilitated the establishment of these partnerships along with the challenges they faced. Data were gathered from two Pennsylvania sites (Philadelphia and Erie), using documentation and records along with interview data that were gathered during site visits. The principal findings include: (a) The AAAs experienced difficulty in "selling" their services to the MCOs. (b) There were misconceptions on the part of the MCOs and AAAs regarding the specific services that the partner would providemisconceptions that only became obvious once the projects were operational. (c) Concerns about consumer's outcomes appear to have been lost in the shuffle as both projects focused on "completing the in-home assessments and producing a caring plan. " (d) It appears unlikely that the MCOs will consider reimbursing the AAAs to deliver a package of social services designed to reinforce community-based care.With the national trend toward managed care, concerns are being voiced about how this will impact the delivery of health care to the elderly. Given the movement of area agencies on aging (AAAs) into the health care arena as a 445 AUTHORS'

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