Background, objective:
The Brazilian Public Health System, provides in its Organic Law the actions of the private sector in health. The public administration partners with the private sector to manage the provision of assistance to the population. The objective is to present the conflicting relationships due to the scarcity of resources and the impacts of this on access and quality of care for the population.

Methods:
Michel Porters Value equation model was used, presenting strategies to improve quality and reduce costs considering the scarcity of resources in public health, applied in the management of the Evandro Freire hospital, which is composed of an emergency room and a hospitalization.

Results:
In the midst of a scenario with restrictions on the minimum functioning of the services contracted by the partnership with the municipal administration, measures were adopted based on a decision matrix, namely: alignment of processes, people and technologies; turnaround to increase operational excellence and reduce the variability of indicators. As a result, there was a gain in production and an increase in the quality of care expressed by care indicators such as the reduction of institutional mortality through the management of care protocols, in addition to the reduction of costs and engagement with the purpose of delivering a result of value to the community. user population of the Public Health System.

Conclusion:
Despite the conflicting situations between the public administration and the hospital complexs management operation in fundraising, the implemented measures impacted the work process and the quality of care provided to the population. The differentiated position with the public power for the recognition of the quality services generated possibilities of negotiation in the partnership of the successful results. Concluded that despite the weakening of public health policies in Brazil, it is possible to deliver valuable results for users Public Health System.