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Local Health Departments in a Managed Care Environment

Community-based Collaborative Efforts

Presenter:

E. Liza Greenberg, R.N., M.P.H., Director, Medical Affairs, American Association of Health Plans, Washington, DC.


One of the opportunities resulting from the increased presence of managed care in communities is the potential for collaboration between local health departments (LHDs) and managed care organizations (MCOs) on important public health issues that can have a positive impact on the health of the community.

Liza Greenberg discussed the rationale for health plans becoming involved in such efforts, noting elements that public health and managed care have in common (e.g., an emphasis on prevention, an interest in measuring and demonstrating outcomes, etc.) and certain health plan accreditation requirements that might provide incentives for collaboration.

After citing examples of such collaboration (e.g., the ZAPAsthma project in Atlanta, Georgia), she concluded by identifying the implications and challenges that the changes in the health care market place upon public health. These included the need for:

  • New roles.
  • Self assessments.
  • New accountability
  • Systems and marketing skills.
  • Efforts to educate managed care about public health.

References

White K, Meyer D. Strengthening the Link between Managed Care and Public Health. HMO Magazine November/December 1995:36-41.

Breslow L. Public Health and Managed Care: A California Perspective. Health Affairs Spring 1996;15(1)92-8.

Dillenberg J. An Imperative Partnership. Healthplan March/April 1996:71-4.

U.S. Dept. of Health and Human Services. Prevention and Managed Care: Opportunities for Managed Care Organizations, Purchasers of Health Care, and Public Health Agencies. Morbidity and Mortality Weekly Report November 17, 1995;44(RR-14).

Melek S, Johnson B, Schryver D. Insights into Managed Care—Operational, Legal and Actuarial. MGM Journal March/April 1997:17-26.

Stewart E. Managed Care Contracting Issues in Integrated Delivery Systems. Journal of Health Care Financing 1996;22(3):75-83.

American Association of Health Plans. Examples of Health Plan Activities. AAHP Fact Sheets—Public Health. Washington, D.C., n.d.


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