Cost and quality trends in direct contracting arrangements

Alan Lyles, Jonathan P. Weiner, Andrew D. Shore, Jon Christianson, Leif I. Solberg, Patricia Drury

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


This paper presents the first empirical analysis of a 1997 initiative of the Buyers Health Care Action Group (BHCAG) known as Choice Plus. This initiative entailed direct contracts with provider-controlled delivery systems; annual care system bidding; public reports of consumer satisfaction and quality; uniform benefits; and risk-adjusted payment. After case-mix adjustment, hospital costs decreased, ambulatory care costs rose modestly, and pharmacy costs increased substantially. Process-oriented quality indicators were stable or improved. The BHCAG employer-to-provider direct contracting and consumer choice model appeared to perform reasonably well in containing costs, without measurable adverse effects on quality.

Original languageEnglish (US)
Pages (from-to)89-102
Number of pages14
JournalHealth Affairs
Issue number1
StatePublished - 2002

ASJC Scopus subject areas

  • Health Policy


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