Alliances: changing focus for changing times.

Alliance networks were supposed to offer members the same buying clout enjoyed by national health care systems and the opportunity to contract with employers as part of a national health care delivery network. But overly optimistic projections about how quickly alliances could reach those goals--and what it would cost to teach them--led to unmanaged growth and disgruntled members. According to our cover story, alliances now are adjusting to changing conditions by adopting strategies to serve the needs of hospitals and systems competing in regional markets.