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Cost And Quality Trends In Direct Contracting Arrangements
Alan Lyles,
Jonathan P. Weiner,
Andrew D. Shore,
Jon Christianson,
Leif I. Solberg and
Patricia Drury
This paper presents the first empirical analysis of a 1997 initiative of the Buyers Health Care Action Group (BHCAG) known as Choice Plus. This initiative entailed direct contracts with provider-controlled delivery systems; annual care system bidding; public reports of consumer satisfaction and quality; uniform benefits; and risk-adjusted payment. After case-mix adjustment, hospital costs decreased, ambulatory care costs rose modestly, and pharmacy costs increased substantially. Process-oriented quality indicators were stable or improved. The BHCAG employer-to-provider direct contracting and consumer choice model appeared to perform reasonably well in containing costs, without measurable adverse effects on quality.
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P. A. Fishman, M. C. Hornbrook, R. T. Meenan, and M. J. Goodman
Opportunities and Challenges for Measuring Cost, Quality, and Clinical Effectiveness in Health Care
Med Care Res Rev,
September 1, 2004;
61(3_suppl):
124S - 143S.
[Abstract]
[PDF]
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