Brain injury constitutes a major health care concern in the US today. Annual budget costs in the US for brain injury rehabilitation total more than $4 billion dollars. Managed care as a system of organizing and financing health care services to control these costs was formally introduced in the early 1990s. Brain injury rehabilitation service providers and administrators in this managed care era face increased pressure to produce successful clinical outcomes in an abbreviated time frame. These outcomes may include consumer satisfaction, return to competitive employment, and attainment of functional goals and rehabilitation potential. Services such as evidence-based practices, precision teaching, shortened versions of neuropsychological testing, can be possible solutions. Implications for rehabilitation administrators are also discussed including, techniques to maximize service provision potential, assuring consumer satisfaction, and balancing research with practice.