This reseach examines the performance rates of management care organizations as stakeholders and the implication for public health. Data on core measures of diabetes care-hemoglobin A1C, serum cholesterol level, eye exam and kidney disease were used. The results show that variations exist in diabetes management within and between managed cares. Realizing the causes of variability within all stakeholders in diabetes care is the key to developing and implementing targeted quality improvement strategies and programs.