The extant literature of modularity suggests two contradictory strategies for conducting supply chain management (SCM). On the one hand, tight supply chain integration is applied to promote continuous communication and collaboration. On the other hand, loose coupling is applied to give large independence to suppliers and to reduce the need for coordination and communication. Both strategies are said to bring benefits e.g. in innovation development. The aim of this study was to analyze how and on what circumstances managers apply loose coupling or tight integration of supply chains in the context of health and social services. We interviewed eighteen public sector supply chain managers from three different municipalities. Analysis revealed four types of loose coupling and they were mostly applied in the formal contracting. However, at the same three types tight integration was applied mainly in the less formal development projects with the same suppliers. As a conclusion it can be argued that the two strategies of SCM – tight integration and loose coupling – do not exclude each other. Instead they are used for different purposes and in different situations in health and social services.