title: Private health purchasing practices in the public sector: a comparison of state employers and the Fortune 500.
abstract: State governments are influential purchasers of health benefits but have not been studied extensively. In a recent survey of senior benefit managers, we examine the extent to which states have followed the private-sector approach to purchasing health care. We found that states have adopted "industrial purchasing" practices similar to those of large private employers but offer greater choice of carriers and pay a higher percentage of premiums. Unions continue to influence health care purchasing in both the public and private sectors. Double-digit increases in health costs and the current budget crisis may force states to align their purchasing practices with the private sector to cut costs.
authors.affiliation: Health Policy and Management Research, JSI Research and Training Institute, Boston, Massachusetts, USA. maxwell@jsi.com
authors.forename: James
authors.initials: J
authors.lastname: Maxwell
authors.forename: Peter
authors.initials: P
authors.lastname: Temin
authors.forename: Tanaz
authors.initials: T
authors.lastname: Petigara
mesh_terms: D002017:Budgets; D003625:Data Collection; D006264:Health Benefit Plans, Employee; D017149:Private Sector; D017150:Public Sector; D013219:State Government; D017749:Total Quality Management; D014481:United States