The contributions of managed care plans to public health practice: Evidence from the nation's largest local health departments

Objective. The authors examine the extent and nature of managed care plans participating in local public health activities, Methods. In 1998, the auth ors surveyed the directors of all US local health departments serving juris dictions of at least 100,000 residents to collect information about public health activities performed in their jurisdictions and about organizations participating in the activities. Multivariate logistic and linear regressio n models were used to examine organizational and market characteristics ass ociated with managed care plan participation in public health activities. Results. Managed care plans were reported to participate in public health a ctivities in 164 (46%) of the jurisdictions surveyed, and to contribute to 13% of the public health activities per-formed in the average jurisdiction. Plans appeared most likely to participate in public health activities invo lving the delivery or management of personal health services and the exchan ge of health-related information. Managed care participation was more likel y to occur in jurisdictions with higher HMO penetration, fewer competing pl ans, and larger proportions of plans enrolling Medicaid recipients. Partici pation was positively associated with the overall scope and perceived effec tiveness of local public health activities. Conclusions. Although plans participate in a narrow range of activities, th ese contributions may complement the work of public health agencies.