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Aim: Political decisions usually emerge from the competing interests of politicians, voters, and special interest groups. We investigated the applicability of an advanced methodological concept to determine whether certain institutional positions in a cooperating network have influence on the decision-making procedures. To that end, we made use of the institutional network of relevant health care and health governance institutions, concentrated in Belgrade, Serbia.Methods: We used a Principal Component Analysis (PCA) based on a combination of measures for centrality in order to evaluate the positions of 25 players in Belgrade"s institutional network. Their directed links were determined by a simulated position approach employing the authors" long-term involvement. Software packages used consisted of Visone 2.9, UCINET 6, and KeyPlayer 1.44.Results: In our analysis, the network density score in Belgrade was 71%. The PCA revealed two dimensions: control and attractiveness. The Ministry of Health exerted the highest level of control but displayed a low attractiveness in terms of receiving links from important players. The National Health Insurance Fund had less control capacity but a high attractiveness. The National Institute of Public Health"s position was characterized by a low control capacity and high attractiveness, whereas the National Drug Agency, the National Health Council, and Non-Governmental Organisations were no prominent players.Conclusions: The advanced methodologies used here to analyse the health care policy network in Belgrade provided consistent results indicating that the intended decentralization of the health care network in Belgrade may be incomplete, still with low participation of civil society representatives. With the present study we set the stage for a broad-range survey based data collection applying the methodology piloted in Belgrade.

PurposeThe purpose of this article is to describe the implementation and results of Finnish activation policy from the viewpoint of integrated services and in the framework of network governance. Special emphasis is given to examining the role of health care as an emergent partner in activation.Design/methodology/approachThe functioning of integrated activation policy is addressed from the perspective of network governance. Network governance refers to an ideal type of governance based on strong strategic partnership and joint action. In Finland the one‐stop model of LAFOS represents a culmination of integrated activation policy. Implementation and results of LAFOS highlight the governance demands of joined‐up service delivery. Health care proposes yet another viewpoint to the development. The analysis is based on the results of two national evaluations.FindingsNetwork governance has been a good starting point in Finnish activation policy for creating a client‐centered approach and for the co‐ordination of separate resources and services. However, problems with legitimacy and accountability seem hard to overcome in the network context. Elements of different types of governance are mixed in activation policy while network governance remains in transition. In Finland, health care has been an essential party to activation, and its role is getting stronger. The challenge is to incorporate health and work ability into a wider concept of employability and capability in society.Originality/valueThe article presents an analysis of the unique model of joint services in activation, LAFOS, and its governance. It also contributes to the discussion of the role of health care in activation and integrated activation policy.

Abstract Background Health care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care. However, research on the governance of health care networks lags behind. The research aim of our study is to explore the type and importance of governance structure and governance mechanisms for network effectiveness. Methods The study has a multiple case study design and covers 22 health care networks. Using a configuration view, combinations of network governance and other network characteristics were studied on the level of the network. Based on interview and questionnaire data, network characteristics were identified and patterns in the data looked for. Results Neither a dominant (or optimal) governance structure or mechanism nor a perfect fit among governance and other characteristics were revealed, but a number of characteristics that need further study might be related to effective networks such as the role of governmental agencies, legitimacy, and relational, hierarchical, and contractual governance mechanisms as complementary factors. Conclusions Although the results emphasize the situational character of network governance and effectiveness, they give practitioners in the health care sector indications of which factors might be more or less crucial for network effectiveness.

Abstract
We develop a model in which two insurers and two health care providers compete for a fixed mass of policyholders. Insurers compete in premium and offer coverage against financial consequences of health risk. They have the possibility to sign agreements with providers to establish a health care network. Providers, partially altruistic, are horizontally differentiated with respect to their physical address. They choose the health care quality and compete in price. First, we show that policyholders are better off under a competition between conventional insurance rather than under a competition between integrated insurers (Managed Care Organizations). Second, we reveal that the competition between a conventional insurer and a Managed Care Organization (MCO) leads to a similar equilibrium than the competition between two MCOs characterized by a different objective, i.e. private versus mutual. Third, we point out that the ex ante providers' horizontal differentiation leads to an exclusionary equilibrium in which both insurers select one distinct provider. This result is in sharp contrast with frameworks that introduce the concept of option value to model the (ex post) horizontal differentiation between providers.

Combatting chronic disease (prevention and treatment of obesity, diabetes, heart health, and stroke) requires action at the local level, both to educate the public and to provide health services. Effective collaboration among local organizations devoted to educating the public about, and treating patients of, these diseases is a key component of successful health care. To better understand local efforts, a social network analysis of five local health care networks spanning eight counties in Maryland was conducted. The purpose of this exploratory research was to discover whether collaborative networks exist at the local level, to map the networks, and to assess their strengths and needs.

How can public policy improve upon and fix the mess of U.S. health care? In a new book, health economists Amy Finkelstein (MIT) and Liran Einav (Stanford) argue that's the wrong question. Instead, they suggest we ask: What is it that U.S. health policy should try to accomplish?

Finkelstein, also a MacArthur Genius grantee, joins Bethany and Luigi to discuss health care as a social commitment and to make the case for free, automatic, and universal coverage for a basic set of medical services. She argues why the current patchwork system of incremental reforms isn't the answer, why insurance is not the lever to reduce racial disparities in health inequality, and why we must "tear down the system and build from the ground up."

Finkelstein and Einav's new book, "We've Got You Covered: Rebooting American Health Care," is out now.