New York State's Prenatal Care Assistance Program, and enhanced care program based on public health principles, is in the process of being transformed into Medicaid managed care. The program described in this article, namely, a Medicaid managed care health maintenance organization and its interaction with one hospital's care of women, especially pregnant women, serves to illustrate how traditional public health values and managed care principles may be linked. This linkage is a starting point to developing a community's involvement in its own health, although it is too early from our experience to note a lasting effect on improved pregnancy outcomes.