Ensuring health care quality: a purchaser's perspective--a health care coalition

This paper explores how one health care purchasing coalition in Minnesota, the Buyers Health Care Action Group (BHCAG), has taken an active role in restructuring its local health care market. BHCAG started with the belief that the consumer should be the motivating force in health care delivery. Unfortunately, providing consumers with the information and incentives they need to make informed, effective health care decisions has triggered numerous problems. This paper examines groups of providers who network to form care systems, and explores the roles of consumers, employers, and health plans in the current market. It identifies specific methods for gathering data and distributing information to the consumer, and discusses the problems associated with attempting to implement quality improvement, as well as the questions that arise when the market does not support those improvements.