This paper explores the relationship between horizontal policies and hybridity in public service organizations (Denis et al. 2015). Hybrid organizational forms are analyzed as responses or adaptations to multiple, sometimes conflicting, policy expectations (Skelcher & Smith 2015; Oliver 1991). Empirically, the paper presents findings from a case study of the central administration of healthcare in Stockholm (Region Stockholm), Sweden. It examines the confluence of horizontal policies on sustainability, strategic public procurement and crisis preparedness in the governance of private healthcare providers in Region Stockholm.Based on interviews and a document analysis conducted in 2024, the study provides insights into how these policies compete for prioritization, leading to different organizational adaptations. These include organizational segmentation, where functions related to sustainable public procurement and contract management of private healthcare providers are compartmentalized into separate structures. In contrast, policies on crisis preparedness and resilience have been more thoroughly integrated into the core functions of healthcare management. By examining organizational adaptations to horizontal policies, the paper contributes to the ongoing discussion on the relationship between public policy and the hybrid forms of organization.