Large employers and their coalitions: exploring a hospital constituency

Hospitals may increasingly find large employers banding together in coalitions. Based on focus group data, insights from one coalition and a sample of its members are offered as an aid in understanding the circumstances under which such coalitions and their members resemble other "industrial buyers" and the circumstances under which they represent an adversarial constituency for hospital administrators. These data suggest that the cost of care and the trend of cost increases dominate the thinking of benefits managers; that these managers believe many corporations will work with fewer, more carefully selected providers in the future, and that therefore employee choices will be further restricted; and that the relationship between large employers or employer coalitions and hospitals depends on the employer's role and the provider's marketing orientation.