Not-So-Strange Bedfellows: Models of Interaction between Managed Care Plans and Public Health Agencies

• Published in: The Milbank quarterly Vol. 75; no. 1; pp. 113 - 138
• Main Authors: Halverson, Paul K., Mays, Glen P., Kaluzny, Arnold D., Richards, Thomas B.
• Format: Journal Article
• Language: English
• Published: Oxford, UK and Boston, USA Blackwell Publishers, Inc 01.01.1997; Blackwell Publishers; Blackwell; Blackwell Publishing Ltd; Milbank Memorial Fund
• Subjects: Alliances; Community health; Community health services; Contract Services; Cooperation; Delivery Systems; Health care; Health care delivery; Health care organizations; Health Maintenance Organizations; Health Maintenance Organizations - organization & administration; Health Planning; Health policy; Health services; Health Services Accessibility; Humans; Intercommunity cooperation; Interinstitutional Relations; Interorganizational Relations; Managed care; Managed Care Programs - organization & administration; Managed health care; Medicaid; Medical sector; Models, Organizational; Original; Policy Making; Population planning; Preferred Provider Organizations - organization & administration; Preventive medicine; Professional relationships; Public Health; Public Health Administration; Public health agencies; Public health departments; Quality of Health Care; Sociology; Sociology of health and medicine; United States; USA; United States Of America; United States; Public Health; Organization; Cooperation; Interaction; Coalition; Economical Management; Strategy; Interorganizational relation; Planning; Typology; Institutions
• ISSN: 0887-378X; 1468-0009
• DOI: 10.1111/1468-0009.00046

Alliances between managed care plans and public health agencies are a growing phenomenon in local health care markets, with profound implications for health care quality, cost, and accessibility. A typology of interorganizational relations between managed care plans and local public health agencies is drawn from observations of over 60 public health jurisdictions. Relations are described along three dimensions corresponding to the strategic intent, functional operation, and structural design of each alliance type. The identified models of interaction reveal the motivations for forming alliances, the mechanics of their operation, and the possible outcomes. These alliances suggest that a wide range of interorganizational strategies is possible in order to pursue the shared interests of local public health agencies and managed care plans. Nonetheless, public health agencies may face challenges in forging managed care alliances that benefit community-wide populations and that are open to participation by the full spectrum of health care providers in the community.