Theory and Reality of Value-Based Purchasing: Lessons from the Pioneer
Table 1. Employer Purchasing Initiatives
|Whom Do They Target?||What Do They Want to Know?||Where Do They Get It?||How Do They Communicate It?|
|General Motors, Digital, GTE, Pacific Business Group on Health, Gateway Purchasing Assoc., Chicago Business Group on Health||Patient satisfaction, incidence of early intervention, preventive care measures, health outcomes, accessibility of care||HEDIS 2.5-3.0, consulting firms, NCQA accreditation, site visits, satisfaction surveys (will use CAHPS® when available), FACCT||Report cards on plans (mainly satisfaction data), Internet|
|Health care systems|
|Buyer's Health Care Action Group(1) (Minneapolis-St. Paul), Community Health Purchasing Corporation (Central Iowa)||Patient satisfaction, health outcomes, willingness to provide quality data||Practice guidelines, FACCT, surveys||Profiles of care systems accessible to consumers at kiosks in workplace, commercial settings; Internet|
|Dallas-Ft. Worth Business Group on Health, Health Action Council of Northeastern Ohio (1), Health Care Cost Containment Council (PA)(1)||Conformance with best practices, clinical outcomes (risk-adjusted mortality rates, readmission rates, complication rates)||Critical pathways, JCAHO, system vendors (e.g., MediQual, Apache)||Report cards on hospitals in Cleveland, St. Louis, Tampa, etc.; planned in Dallas-Ft. Worth|
|Dallas-Ft. Worth Business Group on Health, Pacific Business Group on Health, Pacific Bell||Patient satisfaction, conformance with protocols, guidelines; experience, training; incidence/resolution of malpractice claims; clinical outcomes||Physician value, check survey, TMQC accreditation, benchmarking, physician profiling reports from system vendors||Limited activity to date|
(1) Not profiled in this study.
Note: HEDIS=Health Plan Employer Data and Information Set, NCQA=National Committee for Quality Assurance, CAHPS®=Consumer Assessment of Health Plans, FACCT=Foundation for Accountability, JCAHO=Joint Commission on Accreditation of Healthcare Organizations, TMQC=The Medical Quality Commission.