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

Table 1. Employer Purchasing Initiatives

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Whom Do They           What Do They        Where Do They         How Do They
  Target?              Want to Know?          Get It?           Communicate It?
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Health plans
General Motors,    Patient satisfaction,  HEDIS 2.5-3.0, con-   Report cards on 
Digital, GTE,      incidence of early     sulting firms, NCQA   plans (mainly 
Pacific Business   intervention, preven-  accreditation, site   satisfaction
Group on Health,   tive care measures,    visits, satisfaction  data), Internet
Gateway Purchas-   health outcomes,       surveys (will use             
ing Assoc., Chi-   accessibility of care  CAHPS® when 
cago Business                             available), FACCT
Group on Health

Health care systems
Buyer's Health     Patient satisfaction,  Practice guidelines,  Profiles of care 
Care Action        health outcomes,       FACCT, surveys        systems accessible
Group(1) (Minne-   willingness to                               to consumers at
apolis-St. Paul),  provide quality data                         kiosks in work-
Community Health                                                place, commercial 
Purchasing Cor-                                                 settings; Internet
poration (Central 
Iowa)

Hospitals
Dallas-Ft. Worth   Conformance with best  Critical pathways,    Report cards on
Business Group on  practices, clinical    JCAHO, system ven-    hospitals in
Health, Health     outcomes (risk-        dors (e.g., MediQual, Cleveland, St. 
Action Council of  adjusted mortality     Apache)               Louis, Tampa, etc.; 
Northeastern       rates, readmission                           planned in Dallas- 
Ohio(1), Health    rates, complication                          Ft. Worth 
Care Cost Contain- rates)  
ment Council 
(PA)(1)

Physicians
Dallas-Ft. Worth   Patient satisfaction,  Physician value,      Limited activity
Business Group on  conformance with       check survey, TMQC    to date
Health, Pacific    protocols, guidelines; accreditation, bench-
Business Group on  experience, training;  marking, physician
Health, Pacific    incidence/resolution   profiling reports 
Bell               of malpractice claims; from system vendors
                   clinical outcomes
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(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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