The question becomes, who will manage managed care and what will be used as a basis for rational decision making? It has been suggested that a policy-regulating body composed of health care providers, payors, and patients be formed to oversee the process of health care reform and to discourage profit-driven managed care practices. It is particularly appealing to incorporate health care consumers into this process as representatives of evolving societal values. To make rational decisions, the proposed regulatory body will need data. In this regard the discipline of clinicoeconormics could provide information on the effectiveness and relative value of health care interventions. Geropsychiatrists must be willing to join the effort to learn about and participate in clinicoeconomics to shift the debate from the bottom line of a balance sheet to the preservation of quality care for the elderly and mentally ill.