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Previous research on interaction behavior among organizations (resource exchange, collaboration, communication) has typically aggregated those behaviors over time as a network of organizational relationships. The authors instead study structural-temporal patterns in organizational exchange, focusing on the dynamics of reciprocation. Applying this lens to a community of Italian hospitals during 2003–7, the authors observe two mechanisms of interorganizational reciprocation: organizational embedding and resource dependence. The authors show how these two mechanisms operate on distinct time horizons: dependence applies to contemporaneous exchange structures, whereas embedding develops through longer-term historical patterns. They also show how these processes operate differently in competitive and noncompetitive contexts, operationalized in terms of market differentiation and geographic …