For the past 2½ years, four Social Health Maintenance Organization (SHMO) sites have been delivering integrated, prepaid, acute, and chronic care to Medicare beneficiaries. Because SHMOs enroll a mix of able-bodied and frail members, sites have had to develop systems for identifying disabled members who may qualify to receive expanded chronic care benefits. Selection criteria for targeting expanded benefits, and their implementation affect costs, outcomes, and equity. Described are the sites' targeting policies and analyzed are the complexities of operationalizing targeting systems in four different settings.