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Health services have long been delivered via some form of network, with substantial differences in the variety and scope of service delivery based on age, income, and other socio-economic indicators. The passage of health care reform in the U.S. illustrates that Americans seek balance and equity in a complex health care system. This national study is the first of its kind to analyze county government influences, environmental pressures, and community resources in the context of health care network performance. Ultimately, this study in complexity learned valuable lessons that can be used by both public and private health policy decision-makers. First, county involvement in community based health care networks results in a benefit that reverberates during economic stress- the leveraging of resources. Second, public-private initiatives are fundamental to reducing disparities in health care access. Third, health care networks improve access to health care for uninsured and underinsured people. The analyses provided within this book lead to useful recommendations for both administrators and researchers alike.

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Hillary Knepper, MPA, PhD is an assistant professor at Pace University. Her research interests include health care, county government, complexity in public-private service delivery, and governance. Dr. Knepper has over 20 years in the nonprofit and public sectors.

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