IMPACT OF PURCHASING STRATEGIES ON LOCAL HEALTH-CARE SYSTEMS

Efforts to control health care costs increasingly rely on purchasers t o seek the best value for their investment. In this examination of pur chasing strategies in fifteen communities, most purchasers employed tr aditional strategies to reduce their direct costs, such as shifting co sts to employees and switching from indemnity to managed care plans. F ewer purchasers-mostly large companies, public agencies, and coalition s-were using more resource-intensive strategies such as direct contrac ting with providers or selecting plans based on quality to improve val ue or efficiency. Although both sets of strategies might help to reduc e costs, they are not yet changing the delivery of health care in loca l communities.