Private health purchasing practices in the public sector: a comparison of state employers and the Fortune 500.
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.
Maxwell
James
J
Health Policy and Management Research, JSI Research and Training Institute, Boston, Massachusetts, USA. maxwell@jsi.com
Temin
Peter
P
Petigara
Tanaz
T
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