Cost Containment Study Data Repository

PA 15-146 directed the Health Care Cabinet to study health care cost containment models in six states:  Massachusetts, Maryland, Oregon, Rhode Island, Washington and Vermont.  The Legislature asked the Cabinet to identify successful practices or programs that may be implemented in the state for the purpose of: 

1. Monitoring and controlling health care costs;
2.  Enhancing competition in the health care market;
3. Promoting the use of high-quality health care providers with low total medical expenses and prices;
4. Improving health care cost and quality transparency;
5.  Increasing cost-effectiveness in the health care market; and
6.  Improving the quality of care and health outcomes.

The following information represents the research that was collected as part of this study.  It was collected between March and December 2016 and was accurate at the time of publication.   Since state health care policy is dynamic, please keep in mind the date in which you’re viewing this information as state policy or practice may have changed.

This research is organized by state and, within each state, into seven domains of inquiry as follows:

1. Administrative and clinical data collection, analysis and reporting.  State efforts at health care cost containment need to be informed by current data on cost and quality of the health care system.  Therefore, this domain sought to identify what data are collected by states, and by which entity, and how states publish the information for consumer use and policy making.
2. Medicaid purchasing and coverage strategies.  Medicaid is a central health care program for any state and this domain describes the activities that each state have taken within their Medicaid program to control health care costs.
3. State employee health plan coverage and payment strategies.  This section describes the activities that each state have taken with their state employee health plan to control health care costs.
4. State actions to enhance competition in the marketplace.   Highly consolidated insurer and provider markets can sometimes lead to health care price increases.  This domain describes what the six states have done to ensure healthy competition within their state as a strategy for cost containment.
5. State regulatory actions.  This domain describes the regulatory role each of the six states played with respect to health care, and which of those regulations are aimed at cost containment.
6. Payment and delivery system reform. Many states are the drivers of payment and delivery system reform.  This domain describes primarily what actions the state has taken to pursue payment and delivery system reform, but also describes key marketplace participants’ activities as well.
7. Environmental context.  It is important to understand the environmental context in which any state is operating – culturally and politically each state is different.  This domain describes what environmental facilitators helped with cost containment policy implementation.

 
A summary of each state's efforts, with detailed analysis is available here.