A community approach to health care competition.

In the Worcester, Massachusetts, area, a community program is making health care more affordable through competition among managed-care health plans. Business and health care leaders have joined to assure that this competition focuses not only on price but also on quality and service, and that it benefits the entire community, including the elderly, poor, and uninsured. This paper describes the progress of the program to date as well as strategies for overcoming obstacles to further success.