Pooled purchasing: Who are the players?

Health Affairs

Volumn 18, Issue 4, 1999, Pages 105-111

  Long, Stephen H ^a   Susan Marquis, M ^a  

^a RAND CORPORATION   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; FORECASTING; HEALTH CARE QUALITY; HEALTH INSURANCE; HOSPITAL PURCHASING; HUMAN; INSURANCE; UNITED STATES;

FORECASTING; GROUP PURCHASING; HEALTH BENEFIT PLANS, EMPLOYEE; HUMANS; INSURANCE POOLS; QUALITY ASSURANCE, HEALTH CARE; UNITED STATES;

EID: 0033160967     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.18.4.105     Document Type: Article

References (23)

1. E.K. Wicks, R.E. Curtis, and K. Haugh, Designing Health Purchasing Alliances/Cooperatives: Federal Policy Issues and Options (Washington: Institute for Health Policy Solutions, 1994).
2. J.A. Meyer et al., Employer Coalition Initiatives in Health Care Purchasing, vols. 1 and 2 (Washington: Economic and Social Research Institute, 1996); and P. Jacobson et al., The Operation of Business Health Purchasing Coalitions (Santa Monica, Calif.: RAND, 1996).
3. J.A. Meyer et al., Employer Coalition Initiatives in Health Care Purchasing, vols. 1 and 2 (Washington: Economic and Social Research Institute, 1996); and P. Jacobson et al., The Operation of Business Health Purchasing Coalitions (Santa Monica, Calif.: RAND, 1996).
4. T.C. Buchmueller, "Managed Competition in California's Small-Group Insurance Market," Health Affairs (March/April 1997): 218-228; and D.J. Lipson and J. De Sa, The Health Insurance Plan of California: First-Year Results of a Purchasing Cooperative (Washington: Alpha Center, 1995). Recent developments under state small-group reform laws and the Health Insurance Portability and Accountability Act (HIPAA) have reduced the likelihood of such risk selection through their regulation of the entire small-group market.
5. T.C. Buchmueller, "Managed Competition in California's Small-Group Insurance Market," Health Affairs (March/April 1997): 218-228; and D.J. Lipson and J. De Sa, The Health Insurance Plan of California: First-Year Results of a Purchasing Cooperative (Washington: Alpha Center, 1995). Recent developments under state small-group reform laws and the Health Insurance Portability and Accountability Act (HIPAA) have reduced the likelihood of such risk selection through their regulation of the entire small-group market.
6. E.W. Hoy, E.K. Wicks, and R.A. Forland, "A Guide to Facilitating Consumer Choice," Health Affairs, (Winter 1996): 9-30.
7. Ibid.; and Meyer et al., Employer Coalition Initiatives.
8. Ibid.; and Meyer et al., Employer Coalition Initiatives.
9. Buchmueller, "Managed Competition."
10. For descriptions of the California alliance, see ibid.; Hoy et al, "A Guide to Facilitating Consumer Choice;" and Lipson and De Sa, The Health Insurance Plan of California. For descriptions of the Connecticut and Florida alliances, see Hoy et al., "A Guide to Facilitating Consumer Choice;" and N.L. Ross, "Health Insurance Purchasing Cooperatives: How Does Your Cooperative Grow?" Journal of the American Society of CLU and ChFC (September 1995): 72-81.
11. For descriptions of the California alliance, see ibid.; Hoy et al, "A Guide to Facilitating Consumer Choice;" and Lipson and De Sa, The Health Insurance Plan of California. For descriptions of the Connecticut and Florida alliances, see Hoy et al., "A Guide to Facilitating Consumer Choice;" and N.L. Ross, "Health Insurance Purchasing Cooperatives: How Does Your Cooperative Grow?" Journal of the American Society of CLU and ChFC (September 1995): 72-81.
12. For descriptions of the California alliance, see ibid.; Hoy et al, "A Guide to Facilitating Consumer Choice;" and Lipson and De Sa, The Health Insurance Plan of California. For descriptions of the Connecticut and Florida alliances, see Hoy et al., "A Guide to Facilitating Consumer Choice;" and N.L. Ross, "Health Insurance Purchasing Cooperatives: How Does Your Cooperative Grow?" Journal of the American Society of CLU and ChFC (September 1995): 72-81.
13. For descriptions of the California alliance, see ibid.; Hoy et al, "A Guide to Facilitating Consumer Choice;" and Lipson and De Sa, The Health Insurance Plan of California. For descriptions of the Connecticut and Florida alliances, see Hoy et al., "A Guide to Facilitating Consumer Choice;" and N.L. Ross, "Health Insurance Purchasing Cooperatives: How Does Your Cooperative Grow?" Journal of the American Society of CLU and ChFC (September 1995): 72-81.
14. For descriptions of the California alliance, see ibid.; Hoy et al, "A Guide to Facilitating Consumer Choice;" and Lipson and De Sa, The Health Insurance Plan of California. For descriptions of the Connecticut and Florida alliances, see Hoy et al., "A Guide to Facilitating Consumer Choice;" and N.L. Ross, "Health Insurance Purchasing Cooperatives: How Does Your Cooperative Grow?" Journal of the American Society of CLU and ChFC (September 1995): 72-81.
15. For survey methods, see 1997 Employer Health Insurance Survey: Final Methodology Report (Research Triangle Park, N.C.: Research Triangle Institute, 1998). For Community Tracking Study design, see P. Kemper et al., "The Design of the Community Tracking Study: A Longitudinal Study of Health System Change and Its Effects on People," Inquiry (Summer 1996): 195-206. The twelve states are California, Colorado, Connecticut, Florida, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont, and Washington.
16. For survey methods, see 1997 Employer Health Insurance Survey: Final Methodology Report (Research Triangle Park, N.C.: Research Triangle Institute, 1998). For Community Tracking Study design, see P. Kemper et al., "The Design of the Community Tracking Study: A Longitudinal Study of Health System Change and Its Effects on People," Inquiry (Summer 1996): 195-206. The twelve states are California, Colorado, Connecticut, Florida, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont, and Washington.
17. In the case of participants in the three statewide alliances, specific information about benefits and premiums for health plans made available to employees was obtained through administrative data provided directly by the alliances.
18. We judged the responses to the probes about specific types of pooled purchasing arrangements as less accurate than whether or not some form of pooled purchasing was used.
19. For establishments offering multiple plans, we computed an average premium for the establishment by weighting the premiums for the separate plans by the number of enrollees.
20. The index is the within establishment variation in the characteristic.
21. In California all employees are offered the full roster of plans available through the alliance in their geographic area. In Florida the employer must offer at least two plans and may choose to offer as many others as are available in the region. In Connecticut some employers participating in the alliance do not offer a choice of plans.
22. These premiums were not standardized for benefit differences. Also, we did not test for cost differences in the three states with established purchasing alliances.
23. We plan to do such a study for the three state-wide alliances discussed here.