Benefits researchers may be seeing evidence that trying to improve the quality of health care can help hold down health benefits bills in the real world.

Watson Wyatt Worldwide, Washington, and the National Business Group on Health, have published data supporting the idea that quality pays in a report based on their annual employer benefits survey.

When researchers polled 585 large and midsize employers, they found a wide gap in success at holding down health care costs.

The companies in the top 25% managed to hold cost increases to an average of just 3% per year over the past 2 years.

The companies in the bottom 25% suffered from average annual increases of 11.5% per year.

Efforts to share costs and financial risk with employers turned out to have little correlation with success at holding down health coverage costs, survey team researchers report.

About 29% of the employers surveyed offer health savings accounts, health reimbursement arrangements or both, up from 7% in 2004, and 59% of the employers surveyed agree that personal health accounts may be effective or somewhat effective at controlling health care cost increases.

But the companies in the top 25% in terms of cost containment also made serious efforts to improve the quality of the health care that their employees received, researchers report.

The top performers were 32% more likely than the bottom performers to pay higher rates to higher-quality health care providers or make other efforts to focus on quality of care, the researchers say.

The top performers were also 24% more likely to have condition management programs and other programs that help employees manage their own health, and they were 16% more likely to provide incentives to use health care services appropriately.