How managed care plans contribute to public health practice

Growth in managed care enrollment potentially creates incentives for health plans to become involved in public health activities, such as health promotion and disease prevention interventions, and care for vulnerable populations. Using cross-sectional data from 60 diverse markets, this study explores the extent to which health maintenance organizations (HMOs) form cooperative alliances with local public health agencies to perform such activities. Results from multivariate models suggest that the incentives for cooperation vary substantially with health plan ownership and market structure. In view of recent HMO industry trends, these findings raise questions about the ability of alliances to integrate the practice of public health and medicine on a broad national scale, as some proponents suggest they do.