Challenges of Capacity Building in Multisector Community Health Alliances

This article examines challenges to the success of health alliances between insurers, providers, hospitals and patients. While health alliances hold potential to improve health care for chronic conditions, health alliances struggle to achieve meaningful change in a short period of time.

The authors analyze comparative data from four health alliances in the Aligning Forces for Quality initiative. They conducted 68 interviews with key stakeholders and coded all transcripts for key themes, including infrastructure, governance, stakeholder relationships and participation.

Key Findings:

  • There is no single archetype for a successful health alliance; individual alliances face different challenges and draw on different strengths.
  • Capacity challenges include developing sustainable business models, identifying funding sources, balancing staff roles, and managing various stakeholder interests.
  • Capacity-building is a long-term project that requires learning, reevaluation and readjustment over the time.
  • Environmental and market conditions will influence the development and progression of health care alliances. Trends that support health care alliances include: (1) new movements to strengthen communities, and (2) improving chronic care.

This research indicates that while the coordination of health alliances is complex and challenging, various strategies can strengthen health alliances in their mission to improve chronic care.