The forms of agency in the governance of health homes

Abstract

Health homes promote new approach of health and new relations with users. Within these
homes, health professionals experiment forms of governance that facilitate the coordination
of different logics of action, resulting in more or less innovative collective dynamics without
necessarily modifying the nature of relations between professionals and users. Based on one
in-depth case study, the present article shows that new types of relations only emerge when
health homes governance integrates a political dimension. We first characterize the forms of
strategic agency at play in health homes and discuss the limits of an approach of governance as
a process of regulation between this various and evolutionary forms of agency. We then bring
to the foreground the role of a “political agency” in these new health organizations.