The Department of Social and Health Services contracts with the Kitsap Physicians Service to provide medical assistance in Kitsap and Mason Counties. The Kitsap Physicians Service, a type of health insuring organization, is a physician-controlled medical service bureau. Its medical assistance package is called the Sound Care Plan. Benefits are provided through a network of primary care physicians who act as case managers. Primary care physicians must authorize most non-emergency care. Case management helps to increase quality of care and control costs. The Sound Care Plan began operations in February 1986 with just over 6,100 enrollees. It covers all recipients of public assistance under the Aid to Families with Dependent Children-Regular program. This report examines the first six months of Sound Care program operations. Key findings include: 1. All major Sound Care Plan features were in place and operating smoothly within three months. 2. The sound Care Plan increased the number of physicians providing medical care. 3. Reduced medical assistance costs are expected under the Sound Care Plan. 4. The Sound Care Plan should increase physician incomes through reducing hospital costs. 5. The Sound Care Plan has the potential to restrict access to care.