Health services research in rheumatology is producing important studies that have implications for the provision of care in a changing health care environment. This paper reviews studies relating to issues surrounding the delivery of care to patients, patients' access to medical care, how to provide more cost-effective medical care, and who should be providing medical care. The increasing use of managed medical care provides researchers with the opportunity to examine how changes in medical care delivery affect patient outcomes and the cost of the care that is provided. Policy makers need to be made aware of the research being conducted in health services so that they make informed policy decisions.