The GAO has issued a report entitled, "Group Purchasing Organizations: Services Provided to Customers and Initiatives Regarding Their Business Practices." The report examines group purchasing organizations (GPOs) – entities that negotiate contracts with medical product vendors on behalf of health care providers. Specifically, the report examines: (1) the types of services that GPOs provide and how the GPOs fund these services, (2) initiatives that GPOs have implemented since 2002 to address the questions that had been raised about their business practices, and (3) the reported impact of the GPOs' codes of conduct and other initiatives. With regard to GPO services, the six largest GPOs all reported offering to their customers custom contracting, clinical evaluation and standardization of products, and assessments of new technology, with other services (such as electronic commerce and benchmarking data services) furnished by some of the GPOs. According to the six GPOs, these services were funded either through contract administrative fees received from vendors (which ranged from 1.22% to 2.25% of customer services in 2008) or by charging customers directly for the service. The GAO report also discuses GPO codes of conduct and the Healthcare Group Purchasing Industry Initiative (HGPII) to promote best practices and public accountability among member GPOs. While all of the GPOs in the review reported that these initiatives have impacted GPO contracting practices, innovative product selection, contract administrative fees, potential conflicts of interest, and the transparency and accountability of GPO business practices, the impact of the GPO initiatives reported by customers and vendors interviewed by the GAO varied.