Public-private partnerships: working at the local level to increase the quality and number of medical homes for Medicaid children.

We have described a process in which one state's public health leaders provided a large degree of flexibility at the community level to improve pediatric health care access for children in need. This "room-to-wiggle" allowed program providers to tailor their programs to the specific needs of their communities while remaining faithful to the statewide goals. Among the most promising outcomes of the coordinated efforts to forge public-private partnerships is the continuation of the relationships that developed in the process and the further collaborations they have spawned.