Care management has become a key component in the development of community-based care in many countries, and this paper examines the different care management arrangements for older people's services that are now emerging. It has been United Kingdom government policy since 1989 that the providers of social services develop care management systems, as confirmed in the White Paper, Modernising Social Services. The paper opens with the background to the policy changes and a discussion of the role of care management in the British social care system. Secondly, evidence from the early phases of care management development is examined; and thirdly, the evidence from a major national study of care management arrangements for older people on the patterns of variation on key dimensions is considered.