In the past few years managed care has become the dominant model of health care delivery in the United States. Large companies have spearheaded the move to managed care and have driven the increasing focus on cost containment, the emergence of new organizational forms and contracting arrangements, and efforts at measuring quality in health care systems. Nonetheless, few researchers have examined comprehensively the motivations and methods of large corporate purchasers.
This paper presents findings from a new study of health care purchasing among the largest U.S. corporations. This is the first study to concentrate on the country’s very largest companies: the Fortune 500. It is also uniquely oriented toward the purchasing strategies and practices used by these firms in providing health insurance for their workers. The focus here is not only on the types of benefits purchased by firms, but also on the relationships among firms and their health insurance carriers and health care providers. The companies’ selection of carriers, negotiation of premium rates, and quality management merit further investigation.
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