Additional Resources

The Manatt State Cost Containment Update


A PDF of our update is also available here.

Other Cost Containment Resources

  • The California Health Care Foundation’s new issue brief outlines developing state-level benchmarking programs and their progress in establishing cost growth targets and other program components.
  • The Commonwealth Fund’s recent issue brief series outlines ten strategies for states to address cost growth in the commercial market, with the most resource-intensive strategies listed first.
  • M. J. Pany, M. Chernew and L. S. Dafny’s recent Health Affairs piece discusses two key strategies for limiting health care prices at the state level, including comprehensive price caps supported by rate review and out-of-network price caps.
  • A Kaiser Family Foundation (KFF) study finds that large shares of non-elderly households do not have enough liquid assets to meet typical health plan cost-sharing amounts—an effect that is exacerbated for lower-income households, which were much less likely to have liquid assets available.
  • 32BJ’s new report examines hospital prices and outlines four policy interventions for addressing rising health care costs, including aggregated purchasing coalitions, restricting anti-competitive contracting by large hospital systems, ensuring nonprofit hospitals act in accordance with nonprofit hospitals, and leveraging rate regulation and global budgets.
  • The 1% Steps for Health Care Reform Project compiles literature from leading scholars on specific challenges contributing to rising health care costs and offers specific policy actions for reform.

To return to the Manatt Cost Containment Update Home Page, please click here.

 

Cost Containment Resources

  • Office of Health Strategy (OHS) Roadmap for Strengthening and Sustaining Primary Care, Connecticut Office of Health Strategy (OHS). Draft of as November 2021. In collaboration with the state Department of Social Services (DSS), OHS has released a primary care roadmap to strengthen and sustain primary care in Connecticut, as required under Governor Lamont’s Executive Order No. 5. The roadmap outlines four key steps to advance this goal:
    • Establish core functional expectations of primary care practice teams;
    • Apply resources and supports to help practice teams master the core function expectations;
    • Develop methods to assess and recognize practice team performance; and,
    • Make available voluntary primary care alternative payment models, beyond fee-for-service (FFS), to reimburse primary care.
  • The Toxic Impacts of High Health Care Costs on Coloradans, Colorado office of Saving People Money on Health Care (OSPMHC), October 2021. This report by the OSPMHC highlights the impacts of high health care costs on Coloradans, and discusses the need to address underlying drivers of high health care costs and reduce out-of-pocket expenses for patients; the burden Coloradans face in navigating a complex and inaccessible health care system; and the barriers patients face in accessing care.
  • Rhode Island Market Summary based on 2022 Rate Filing Submissions as of October 15, 2021, Office of the Health Insurance Commissioner (OHIC) and Gorman Actuarial. October 15, 2021. using 2022 rate filing data, OHIC examined trends in health insurance market membership, membership characteristics, market share by insurer, premium and cost-sharing trends over time, and more.
  • How ACA Marketplace Premiums Are Changing by County in 2022, Kaiser Family Foundation (KFF). December 7, 2021. A KFF analysis of rate filings, state exchange websites, and Healthcare.gov finds that for the fourth consecutive year, premiums for ACA Marketplace benchmark silver plans are decreasing, on average, nationally, with many enrollees qualifying for additional, temporary American Rescue Plan Act (ARPA) subsidies that further improve health insurance affordability for 2022.
  • How Price Regulation Is Needed to Advance Market Competition, Health Affairs, January 2022. In a new Health Affairs policy insight, Robert A. Berenson and Robert B. Murray re-examine traditional assumptions around price regulation and competition in the US health care market, and urge policymakers to consider regulations that limit out-of-network provider prices and establish flexible hospital budgets to address high and rising provider prices in the US.

To return to the Manatt State Cost Containment Update Home Page, please click here.

 

State Reports

  • Massachusetts’ HPC released its 2021 Annual Cost Trends Report, which examines the state’s cost growth trends in 2019 and includes five overarching policy recommendations for lawmakers, providers, payers, employers, and other health care market participants to create a more affordable and accessible high-quality health care system. These recommendations include key actions for the state to take to address the intersecting challenges of cost containment, affordability, and health equity.
  • In June, Connecticut updated the figures within its Healthcare Affordability Index (CHAI) to reflect new, temporary premium subsidies enacted in the American Rescue Plan Act (ARPA) enacted in March 2021, and additional state subsidies enacted by the state budget in June 2021. The CHAI measures the impact of health care costs, including premiums and OOP expenses, on a household’s ability to afford all basic needs. Following the passage of temporary ARPA subsidies, the CHAI estimated an additional 35,000 Connecticut households would see improved health care affordability; additionally, the new state subsidies were estimated to provide additional assistance to another 40,000 people in the state.

Additional Reports Relating to Health Affordability and Cost Containment

  • Reducing Health Care Spending: What Tools Can States Leverage? (The Commonwealth Fund, August 18, 2021). The Commonwealth Fund’s latest issue brief examines the range of strategies available to states to address rising health care costs, including promoting competition, reducing prices through regulation, designing incentives to reduce the utilization of low-value care, and broader, systemwide policies such as imposing spending targets and promoting payment reform. Recognizing that different states are likely to take varying approaches to address this issue, the brief articulates the value of health policy commissions in particular in advancing reform by supporting initiatives of existing state agencies or by directly implementing new policies themselves.
  • A Data Use Strategy for State Action to Address Health Care Cost Growth (Milbank Memorial Fund, June 24, 2021). States with health care cost growth targets conduct two types of analyses on collected payer and provider data: (1) routine standardized analyses to monitor the impact of the cost growth target; and (2) in-depth, ad hoc analyses of potential drivers of high costs, cost variation, and cost growth identified from routine reports, potentially using other data resources to do so. The latest brief from the Milbank Memorial Fund discusses the design of the first category of analysis, providing an analytic framework that asks, “Where is spending problematic? What is causing the problem? And who is accountable?” The report also outlines a series of 11 recommended standard reports that apply the framework to state cost growth analyses.
  • State Benchmarking Models: Promising Practices to Understand and Address Health Care Cost Growth (Manatt Health, June 17, 2021). As state cost growth benchmarking models continue to develop and evolve, Manatt Health examines how states are shaping their programs, how they are supporting health care cost transparency, and other emerging data use cases, including identifying trends in patient cost-sharing and driving investments in primary care. This report also identifies opportunities for standardization in data collection and analysis as more states continue to establish cost growth benchmarking programs.

To return to the Manatt State Cost Containment Update Home Page, please click here.

 

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