How has BHCAG affected consumers’ awareness of quality and switching behavior? Can the BHCAG model be used elsewhere? Researchers at the University of Minnesota assessed the effectiveness of the Buyers Health Care Action Group's (BHCAG) efforts to promote employee consciousness of quality differences among care systems and considered whether the BHCAG model can be exported to other communities. As part of this evaluation, they studied the effectiveness of BHCAG’s annual “quality award” in raising consumer awareness of quality and increasing their use of quality information when selecting a care system. They also investigated the reasons that employees switch care systems and the role of perceived quality differences in that decision. The researchers assessed whether the BHCAG model is uniquely suited to the Twin Cities or if it is flexible and attractive enough to purchasers and providers to be successful in other market areas and in other market conditions. The researchers extended the work done under their recently-completed HCFO evaluation of BHCAG. This study further informs policymakers and purchasers about direct-contracting and its ability to be transferred to markets beyond the twin cities.