Business Coalitions Face Challenges as Purchasers of Quality Low-Cost Health Care

Evaluation of business initiatives in health care purchasing

Between April 1995 and September 1996, the Economic and Social Research Institute, Washington, examined the design, implementation, and outcomes of new purchasing strategies in six business coalitions across the country—a sample of the most innovative and advanced purchasing groups in the United States.

The objective was to provide both policymakers and employers with more detailed information on the effectiveness of community-based health care coalitions in reforming the way health care is purchased.

This project was part of the Robert Wood Johnson Foundation (RWJF) national program Changes in Health Care Financing and Organization (HCFO).

Key Findings

  • Although some employer-based coalitions are moving toward value-based purchasing, most coalition purchasing still remains focused on saving money.

  • Many coalitions are developing initiatives to foster improvements in the way care is delivered—research projects that measure patient satisfaction, studies of best practices, and efforts to measure outcomes, to name a few.

  • Coalitions are negotiating lower health plan premiums and lower provider charges for their members.

  • Characteristics that influence the effectiveness of coalitions in meeting their goals include:

    • Participation by the largest employers in the region.
    • The consolidated purchasing power of the coalition.
    • The size of the community.
    • Dynamic coalition leadership.
    • The quantity and quality of other coalition staff.

    The researchers concluded that all six alliances studied were successful to some degree.

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