NOT-SO-STRANGE BEDFELLOWS - MODELS OF INTERACTION BETWEEN MANAGED CARE PLANS AND PUBLIC-HEALTH AGENCIES

Alliances between managed care plans and public health agencies are a growing phenomenon in local health care markets, with profound implica tions for health care quality, cost, and accessibility. A typology of interorganizational relations between managed care plans and local pub lic health agencies is drawn from observations of over 60 public healt h jurisdictions. Relations are described along three dimensions corres ponding to the strategic intent, functional operation, and structural design of each alliance type. The identified models of interaction rev eal the motivations for forming alliances, the mechanics of their oper ation, 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 for ging managed care alliances that benefit community-wide populations an d that are open to participation by the full spectrum of health care p roviders in the community.