How does direct purchasing of health care from physician groups, rather than relying on employers to purchase these services, affect consumer decision-making, utilization, and costs and quality of services received? Researchers at the University of Minnesota (with subcontractors at Johns Hopkins University) conducted a broad-based evaluation of the impacts of the Buyers Health Care Action Group Initiative in Minnesota. The Buyers Health Care Action group (BHCAG) contracts directly with non-overlapping groups of physicians called Competing Care Systems (CCS), which is offered to employees. BHCAG collected and disseminated extensive information on outcomes, quality and costs to employees, who could choose a Competing Care System directly (without relying on their employer to contract with the CCS). To assess the impact of the BHCAG initiative on health care organizations and the medical care system, researchers collected data through structured, in-person interviews with decision makers in CCSs continuously throughout the study period. They also collected written documents, when available. To assess the impact on consumer decisions, they conducted focus groups of BHCAG employees and also conducted interviews with BHCAG staff and employers. To assess the impact of the BHCAG initiative on health care delivery, they developed person-oriented analytical files from BHCAG claims data files and computerized enrollment files. The objective of the evaluation was to provide policymakers with information on how this experiment in direct purchasing of health care works, and to examine whether, and how, such a managed competition model could be implemented in other areas.