NATIONAL REPORTS-The diverse immigrant population is changing managed care on several fronts, and providers and executives alike are working to respond to the unique needs of this group.

"Immigrants have the same healthcare needs as anyone else and all the more so because, in many cases, they carry out physical labor activities that are very demanding, for long periods of time," says Jim Arriola, president and CEO of Sekure Healthcare.

According to Arriola, 54% of California's uninsured are Latino, and their high uninsured rate is largely because of the low rate of health insurance provided by their employers: 43% compared with 76% for whites.

In markets where there is competition, customer-focused managed care plans will make these changes in order to grow and retain market share, according to Arriola. "They will look at these changes as a necessary part of business development to better serve the changing population of their market," he says. "They will be more effective in meeting the healthcare needs of their members. In markets without competition, or where managed care plans do not seek to address the changing needs, they will probably see this as negative and be reluctant to make the changes to better serve their population."