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Local Health Departments in a Managed Care Environment

Managing Change

Within Your Local Health Department


Stephanie B.C. Bailey, M.D., M.S.H.S.A., Director of Health, Metropolitan Nashville Davidson County Health Department, Nashville, TN.

This session examined the important question of how local health departments can effectively manage the process of redirecting resources toward new roles and responsibilities in the new health care environment.

Dr. Stephanie Bailey described the major changes that her organization went through in response to the implementation several years ago of TennCare, Tennessee's Medicaid managed care initiative. These included:

  • A shift away from the department's traditional role as a primary care provider.
  • A significant downsizing of department staff levels.

Dr. Bailey provided a number of practical recommendations to participants based upon her experiences. These included:

  • Not losing sight of your organizations' mission.
  • Communicating clearly, openly, and frequently with department staff about the change process.
  • Striving to play a leadership role in presenting a new vision for public health to both departmental staff and the community as a whole.

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