Two largest national alliances fine-tune strategies as health care environment changes. Interview by Howard J. Anderson.

The nation's two largest alliances of not-for-profit hospitals and systems are refining their roles for the 1990s. American Health Care Systems (AmHS) and Voluntary Hospitals of America (VHA) are moving away from strategies designed for competition in the marketplace of the 1980s, and toward helping their members change the way they deliver health care in their communities. While AmHS is promoting its health care reform proposal, VHA sees its existing 29 regional organizations of hospitals as a potential infrastructure for the development of community-based, integrated networks of care as envisioned in the AHA's reform plan. Experts add that the alliances clearly have to go beyond group purchasing to serve the changing needs of their members.