The RAND Corporation's COMPARE initiative provides information and tools to help policymakers, the media, and others understand, design, and evaluate health care policies. The COMPARE Web site presents a range of policy options that allows the user to explore the effects of commonly proposed health care reforms.

This document explores how creating or expanding access to purchasing pools would affect health system performance along nine dimensions. Evidence suggests that purchasing pools would enhance patient experience by increasing health plan choice. Studies of past and current purchasing pools show no reduction in premiums or administrative overhead, compared with small group and individual health insurance markets. It is not clear whether purchasing pools can increase health system reliability or increase coverage. There is no evidence about how purchasing pools would affect spending or health. Purchasing pools face difficult implementation and regulatory hurdles that will vary with the details of the policy.

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