Halverson P K, Mays G P, Kaluzny A D, Richards T B
Department of Health Policy and Administration, School of Public Health, University of North Carolina at Chapel Hill 27599-7400, USA.
Milbank Q. 1997;75(1):113-38. doi: 10.1111/1468-0009.00046.
Alliances between managed care plans and public health agencies are a growing phenomenon in local health care markets, with profound implications for health care quality, cost, and accessibility. A typology of interorganizational relations between managed care plans and local public health agencies is drawn from observations of over 60 public health jurisdictions. Relations are described along three dimensions corresponding to the strategic intent, functional operation, and structural design of each alliance type. The identified models of interaction reveal the motivations for forming alliances, the mechanics of their operation, and the possible outcomes. These alliances suggest that a wide range of interorganizational strategies is possible in order to pursue the shared interests of local public health agencies and managed care plans. Nonetheless, public health agencies may face challenges in forging managed care alliances that benefit community-wide populations and that are open to participation by the full spectrum of health care providers in the community.
管理式医疗计划与公共卫生机构之间的联盟在地方医疗市场中日益普遍，对医疗质量、成本和可及性具有深远影响。基于对60多个公共卫生辖区的观察，得出了管理式医疗计划与地方公共卫生机构之间组织间关系的类型学。关系沿着与每种联盟类型的战略意图、功能运作和结构设计相对应的三个维度进行描述。所确定的互动模式揭示了形成联盟的动机、其运作机制以及可能的结果。这些联盟表明，为追求地方公共卫生机构和管理式医疗计划的共同利益，广泛的组织间战略是可行的。尽管如此，公共卫生机构在建立有利于全社区人群且社区内所有医疗服务提供者都能参与的管理式医疗联盟时可能会面临挑战。
