The Puget Sound Health Alliance in Washington seeks to improve the quality of health care by (1) using guidelines for evidence-based medicine to develop performance reports and (2) aligning incentives in purchasing and consumer decision-making to promote quality and reduce costs. The group's current focus is on developing and disseminating the region's first set of public comparison reports on health care providers across the five counties the alliance represents. By providing the necessary information and tools, the alliance and its participating organizations believe they will be able to align incentives between the supply and demand sides of the health care system and support overall quality improvement. Instrumental to the alliance's successes to date include strong leadership, interdisciplinary teamwork, collaboration among stakeholders, and willingness to compromise. Nevertheless, the alliance faces many challenges, including pressure to produce a long-awaited public report; keeping its stakeholder base invested; and balancing stakeholder needs and concerns.
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