Large employers' selection criteria in purchasing behavioral health benefits

To determine the criteria other than cost large employers use in selecting and monitoring behavioral health benefits, this study interviewed 31 of 44 (70.4%) randomly selected corporations employing at least 5 000 workers. Wh ile more than 60% of employers considered administrative efficiency and pro vider access to be very influential in their selection of behavioral health benefits, only 12.9% (95% confidence interval 0.7%-25.1%) considered clini cal outcomes. Employers who considered clinical outcomes in their purchasin g decision reported significantly greater satisfaction with the quality and cost of their behavioral health benefits. Following selection, 38.7% of co rporations used employee complaints to monitor quality problems in their be havioral health benefits; 3.2% used clinical outcomes. If society expects e mployers to purchase behavioral health care on the basis of quality as well as cost, more employers need better indicators of quality.