[Health consortia: a case study of best practices]

Local Health Consortia have been used as alternatives and innovative models for improving health care provision. They are closely linked to the strategy aimed at regionalizing health care in Brazil and are in keeping with the health sector's administrative reform process, seeking greater efficiency, rationality, and quality in the supply of services to the population. In the development of such forms of cooperation, we view some consortia as weak structures with a short lifespan, while others have survived for considerable lengths of time. This case study on the Penápolis Consortium, the oldest in Brazil (having lasted for 14 years), examines the dynamics of cooperation and the reasons for its sustainability. Its formation is a mixture of restructuring the regional supply and the entrepreneurial spirit of its leaders, along with State incentives. The Consortium's local capacity to solve cases with quality care and flexible management has proven to be an important factor. Participants share the important notion that the operational rules are fair, and the reasons for its success stem from the collective perception of reasonably symmetrical political gains as the result of political cooperation.