Strategic alliances in health care: the challenges of cooperation.

As many industries face uncertain and changing environments, strategic alliances are rapidly emerging as a vehicle for interorganizational cooperation. Similarly in health care, alliances represent a mechanism for organizations to seek collaborative solutions to common problems. Drawing on a general typology, alliances in health care are categorized as service, opportunistic, or stakeholder alliances. Existing health care alliances serve to illustrate and characterize the purpose, structure, and operation of each of the three types. Strategic alliances offer significant challenges in managing the inherently fragile relationships within these emerging organizational forms. These challenges center around issues of commitment (v. control) as the underlying managerial philosophy; expectations for alliance performance; managing relationships, communication, and operations; member participation in alliance programs and activities; and stability of alliances over time. Alliances require new ways of thinking about organizations. Sensitivity to their unique characteristics and understanding the factors that can lead to their success are essential to managing them effectively.