Consensus Administrative Specifications for Health Care Cost Analyses

Some states, including those with cost growth targets, are tracking health spending and building the capacity to examine health care cost drivers. To date, some states have borrowed methods for measuring health spending and its individual components from each other, but substantive differences remain in states’ approaches. 

Robust consensus definitions for health care service categories like primary care or medical pharmacy, and methodologies for tracking spending in these areas, can strengthen analyses and facilitate cross-state comparisons. They also have the potential to strengthen the national discussion around health care cost drivers and cost growth targets and could result in greater uptake of state strategies to mitigate cost growth and prioritize increased investment to improve population health. 

To meet this need, two Peterson-Milbank Program for Sustainable Health Costs–supported work groups of staff and contractors from several states, facilitated by Bailit Health, have established consensus definitions and methodologies for health care cost driver analyses and cost growth target programs (Consensus Administrative Specifications for Health Care Cost Driver Analyses; Consensus Administrative Specifications for Health Care Cost Growth Target Programs). See a Milbank blog by Jessica Mar and Sarah Kinsler for an overview of these products.

Al of these resources complement “Making Health Care More Affordable: A Playbook for Implementing a State Health Care Cost Growth Target, 2025 Edition,” recently re-released, which provides a program design and implementation roadmap for states that are interested in, or in the process of, establishing a target.