States Poised to Be Leaders on Cost Control in Health Care

Nurses at the University of Chicago Medical Center in Chicago work in the emergency room at the hospital, November 2010. Source: AP/M. Spencer Green

Washington, D.C. —(ENEWSPF)–April 11, 2016. A new report from the Center for American Progress outlines how states are well-positioned to be leaders in implementing policies to help control health care costs and improve quality. Many of the reforms available to states—such as setting a health care cost growth goal or establishing a statewide scorecard—can be accomplished at little to no cost but are capable of making a big impact. Others, such as scaling evidence-based home visiting statewide, require upfront investments but then pay for themselves in future cost savings. States are natural leaders in this space, since they have considerable authority over the regulation of health insurance and the provision of health care within their borders.

As CAP notes in the report, a number of states are already innovating in this area and seeing positive results for local government, health care providers and payers, and consumers. Maryland and Massachusetts are among the state leaders in setting forth cost control reforms, but they are not alone in improving the quality and sustainability of their health care systems. With health care costs projected to grow faster than the overall economy, CAP’s report details how nearly two dozen other states are undertaking efforts to alleviate this pressure on their budgets and services.

“We know the Affordable Care Act is working, but we need to do more to sustain the slowdown. Otherwise, spending on health care will continue to crowd out other important investments,” said Topher Spiro, Vice President for Health Policy at CAP. “States should seize these opportunities to provide better care at lower cost.”

The report includes a comprehensive summary of options for state governments to consider and examples of how some states are already putting these ideas into action:

Establish a cost growth goal (Massachusetts, Maryland, and Rhode Island)
Publish a health and cost outcomes scorecard (Maryland and Oregon)
Adopt payment and delivery system reform goals (Massachusetts, Maryland, Rhode Island, and California)
Implement bundled payments for all payers (Arkansas, Tennessee, Ohio, and Delaware)
Institute global budgets for hospitals (Maryland)
Launch all-payer claims databases (Maine, Colorado, New Hampshire, and Washington)
Expand evidence-based home visiting services (Minnesota and South Carolina)
Improve price transparency (New Hampshire and Massachusetts)
Integrate behavioral health and primary care (Oregon, Washington, and Colorado)
Combat addiction to prescription drugs and heroin (Maryland, Florida, New York, and Rhode Island)
Improve the delivery of long-term care (California, Maryland, Montana, Oregon, Texas, and Missouri)
Align scope of practice with community needs
Institute reference pricing in the state employee plan (California)
Expand the use of telehealth (Maryland, New York, Virginia, the District of Columbia, and Pennsylvania)
Decrease unnecessary emergency room use (Georgia, New Mexico, Indiana, Minnesota, Washington, and Wisconsin)

Read the full report, “State Options to Control Health Care Costs and Improve Quality” by Zeke Emanuel, Joshua Sharfstein, Topher Spiro, and Meghan O’Toole, online here.