How managed care plans contribute to public health practice

Growth in managed care enrollment potentially creates incentives for health plans to become involved in public health activities, such as health promo tion and disease prevention interventions, and care for vulnerable populati ons. Using cross-sectional data from 60 diverse markets, this study explore s the extent to which health maintenance organizations (HMOs) form cooperat ive alliances with local public health agencies to perform such activities. Results from multivariate models suggest that the incentives for cooperati on vary substantially with health plan ownership and market structure. In v iew of recent HMO industry trends, these findings raise questions about the ability of alliances to integrate the practice of public health and medici ne on a broad national scale, as some proponents suggest they do.