Assessing Roles, Responsibilities, and Activities in a Managed Care Environment

A Workbook for Local Health Officials

The Agency for Healthcare Research and Quality (formerly Agency for Health Care Policy and Research) User Liaison Program (ULP) translates, synthesizes, and disseminates health services research findings, in easily understandable and usable formats, to State, local, and Federal policymakers through interactive workshops.

Assessing Roles, Responsibilities, and Activities in a Managed Care Environment: A Workbook for Local Health Officials, is the result of a collaborative effort between ULP and a public health work group comprised of representatives from the National Association of County and City Health Officials (NACCHO), the Association of State and Territorial Health Officials (ASTHO), and the Association of Maternal and Child Health Programs (AMCHP).

The workbook is a 275-page, spiral-bound, 11 1/2" by 8" document with laminated covers. A free copy can be obtained from the Agency Clearinghouse by calling toll-free 800-358-9295 and requesting AHCPR Pub. No. 96-0057.


The monumental changes occurring within the health care marketplace are having a dramatic impact on all health care providers, payers, and policymakers, including local health officials. Determining the proper direction for a local health department (LHD) in the midst of such changes can certainly be a daunting task. The workbook seeks to assist local officials in examining the changing marketplace, and in charting a logical and appropriate future course for their individual LHDs.

The workbook's purpose is not to prescribe what individual LHDs should do or what their roles should be in the future, but rather to highlight the issues and questions that can help local officials assess and implement alternative roles, responsibilities, and activities for their LHDs in a managed care environment.

In particular, the workbook attempts to help LHD officials identify appropriate ways to carry out their core responsibilities in this new environment by identifying key policy initiatives or design features that may be important to consider in LHD's policy development efforts as well as important questions, factors, and the different roles for LHDs raised by the increased prevalence of managed care arrangements.

Chapter Summaries

Each chapter identifies a series of important questions that local health officials should seek to answer in the process of developing a strategic plan for their LHDs. Most conclude with a broader set of questions/issues that should help LHD officials synthesize the information they collect and identify key action steps to be taken or decisions to be made.

After the introduction (Chapter 1), the individual chapters of the document are structured to help LHDs:

Tools and Resources

The workbook includes several assessment tools that LHD's can use, including:

In addition to a list of references, resource appendices are provided:

Current as of January 1997

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