Beyond health care cost containment: creating collaborative arrangements among the stakeholders

The causes of escalating healthcare costs in the United States and many oth er industrial countries are well documented. Less evident are the structura l factors that underlie the increases and their implications for the future . This paper discusses these structural factors, puts them in the context o f the healthcare marketplace, and proposes a way to address them using a co llaborative arrangement among all stakeholders in a healthcare system, call ed value-based partnering. To be successful, the effort must include not on ly final purchasers (such as employers or Medicare in the USA) but all stak eholders in a healthcare system. Each stakeholder must develop a value equa tion in terms that are meaningful to the others, and must identify opportun ities for value-enhancing partnerships. The paper also identifies some of t he impediments to value-based partnering and discusses ways to overcome the m, including the need for senior management intervention within some stakeh older groups, and the importance of collaborative discussions among all sta keholders. Copyright (C) 2001 John Wiley & Sons, Ltd.