The Cincinnati Payer Initiative.

In 1991, four companies (Procter & Gamble, General Electric, Cincinnati Bell, and Kroger) located in Cincinnati, OH, decided to cooperate in a collaborative partnership with hospitals and a health care data consulting firm to get more information about the health care options available in their community. The Cincinnati Quality Initiative was formed with the goal of stimulating competition around quality and value in the health care market place. The 14 hospitals in the Cincinnati area were invited to participate in a 3-year program of investigation and analyses. The Initiative implemented the investigation in order to gather information that could be used to make health care choices for their employees. Hospitals that performed well over the 3-year period-those that improved over time-would then be selected by the Initiative. However, this selection process did not occur. Nevertheless, the 3-year evaluation proved useful because it generated valuable information about the health care options in Cincinnati and spurred competition among the hospitals. It also led to a dramatic reduction in health care costs for those hospitals that agreed to participate in the investigation.