The Maine Health Management Coalition (MHMC), a partner in AF4Q Maine, wanted to encourage its members to seek care from the high quality, cost-effective providers MHMC identified. But MHMC encountered three problems:

1. getting people to use the publicly reported quality information, 
2. helping labor and management to see eye-to-eye on changing benefits to get care at a better value, and
3. offering a business case for providers to improve quality or cost.

The State Employee Health Commission (SEHC), a member of MHMC, had been galvanized into action after the Institute of Medicine’s reports on health care quality were released in 1999 and 2001. Its executive director spent several years helping educate SEHC members on the quality and cost problems they faced and built a group eager to address these problems in a positive way.