Theory and Reality of Value-Based Purchasing: Lessons from the Pioneers: Table 1

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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?
Health plans
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
Hospitals
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
Physicians
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.

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