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How Does Quality Enter into Health Care Purchasing Decisions?

A number of employers, business consortia, and public purchasers are promoting "value-based purchasing" as a way to improve the quality of patient care. Some purchasers are using publicly available information on health plan and provider performance to make their health plan and provider choices, while others are using their market power to drive improvements in patient care and safety. From a review of published literature on value-based purchasing, six key strategies used by purchasers emerge:

  1. Collecting information and data on the quality of care provided by health plans and providers.
  2. Selective contracting with high-quality plans or providers.
  3. Partnering with plans or providers to improve quality.
  4. Promoting “Six-Sigma” quality, an industry-based model for minimizing errors and waste.
  5. Educating consumers on quality issues.
  6. Rewarding or penalizing through incentives or disincentives.

Publication Details



How Does Quality Enter into Health Care Purchasing Decisions?, Neil I. Goldfarb, Vittorio Maio, Chureen T. Carter, et al., The Commonwealth Fund, May 2003