Interpreneurship: a community coalition approach to health care reform

Interpreneurship-networking by coalitions to build innovative institutions to address community and societal problems-has been a vital force in America since colonial times. In this paper, I describe the interpreneurial framework of today: the five steps that seem necessary to effect fundamental change in a community and the four factors that must be considered in attempts to effect change. As an example of this framework, I describe the activity that led to the creation of a health maintenance organization in the early 1970s in Cincinnati. This case study-in which a Blue Cross Plan played a pivotal role-and my discussion of specific avenues for action might be helpful to communities that wish to develop an interpreneurial reform strategy for change.