The business case for quality: case studies and an analysis.

The financial implications of implementing quality improvements are often poorly understood. Simply put, does improving quality yield a return on investment? We examine four cases--management of high-cost pharmaceuticals, diabetes management, smoking cessation, and wellness programs in the workplace--to understand the financial and clinical implications of improving care. We explore costs and benefits, in both the short and the long term, to four stakeholders with different and sometimes conflicting interests: providers, purchasers and employers, individual patients, and society. Finally, we recommend policy changes to better align financial incentives for superior quality of care.