Case management as implemented in programs for the elderly, has focused on interactions between the client and case manager in the areas of assessment, care planning, service plan implementation, and follow-up. Variation in these case management tasks suggests that no single model can be implemented in all local delivery systems. This emphasis on client/case manager interaction has obscured the fact that care planning, a core case management task, is a crucial resource allocation activity and has important consequences for the distribution of resources within a local delivery system. A resource dependence view of interorganizational relationships is useful for analyzing the capacity of case managers to change market conditions by altering service providers' behavior. The extent of discretion over resource allocation and centralization of resource control are key case management design issues. Case management is a middle ground long-term care policy reform option. Its implementation does not require fundamental changes in funding patterns or interorganizational relationships. The middle ground in which case management can be developed as a reform option is wider than present operational experience suggests. Models that expand case management to include authority for resource allocation and implementation of financial incentives to influence market conditions deserve greater attention. (Author/NRB)