Health care organizations often enter into a cooperative arrangement to create safety-net programs and coordinate care. Maintaining effective cooperation in such alliances poses special problems that can be examined using network analysis and explained in game theory terms. A mental health coalition case study is presented using network analysis and game theory interpretations. Had a positive-sum game approach been applied to the coalition's initial design, its subsequent suboptimal performance might have been averted. The application of network analysis plus a game theoretic paradigm has significant implications for improving both the design and the coordination of such coalitions.