peterson milbank

Peterson-Milbank Program for Sustainable Health Care Costs

The Peterson-Milbank Program for Sustainable Health Care Costs supports state-led efforts to make health care more affordable for everyone. Starting with setting a target for reasonable cost increases, states across the country are collecting data on their annual health care spending and analyzing it to find the cost growth drivers. With this information, everyone in the state who has a stake in health care can work together to identify community-wide solutions to improve affordability.

This program is a partnership between the Milbank Memorial Fund and the Peterson Center on Healthcare. Participating states include ConnecticutNew JerseyOregonRhode Island, and Washington. See all state target values and latest performance reports.

What are cost growth targets?

Cost growth targets create a pathway for health care affordability. They serve as an annual statewide goal for health care spending growth that state leaders, health insurers, health care providers, businesses, and consumer advocates have all agreed to and are committed to achieving. With this common goal in mind, everyone can work together to find shared solutions for making health care more affordable in their state.

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  • “To even begin looking at what’s happening in health care spending on a state level rather than national is an enormous accomplishment. Washington has different trends, different players, and a different landscape than other states. A state-specific look at the data is critical. “

    Emily Brice, JD

    Deputy Director, Northwest Health Law Advocates, Washington

  • “The health care cost growth benchmark is an important initiative. We have to be concerned with cost growth in health care because we need health care to be sustainable, affordable, and accessible without impacting quality. I believe that everyone feels they have a stake in that outcome, and that they can contribute to the goals of the initiative.”

    Joanne Borduas, MSN, MBA

    Chief Executive Officer, Community Health and Wellness Center, Connecticut

  • “The cost growth benchmarking initiative has been thoughtful. I think they’ve tried to be very considered in their approach. They’ve gotten buy-in from both providers and payers and made it a collaborative effort. It is a step in the right direction.”

    Al Charbonneau

    Executive Director, Rhode Island Business Group on Health

Highlights

  • Bringing Balance to the Market: A Roadmap for Improving Health Insurance Affordability Through Rate Review

    Read More

  • Lessons Learned from State Efforts to Slow and Shift Health Care Spending 

    Read More

  • A Menu of State Choices for Addressing Unaffordable Growth in Hospital Commercial Prices 

    Read More

  • Resource Library

    Resource Types

    Current Topics

    States

    Publication

    Making Health Care More Affordable: A Playbook for Implementing a State Health Care Cost Growth Target, 2025 Edition

    May 2025
    January Angeles and Erin Taylor
    Introduction  Policymakers across the political spectrum have long recognized the widespread and growing burdens posed by high and rising health care costs,1 but state governments have not looked at cost growth patterns across insurance markets using standard metrics.  As a result, it has been difficult to create a comprehensive and cohesive picture of overall costs […] More

    News Article

    Rhode Island and Massachusetts Step Up to Support Primary Care

    May 2025
    Christine Haran and Mary Louise Gilburg
    On May 12, the Rhode Island Cost Trends Steering Committee and the Office of the Health Insurance Commissioner hosted their annual public forum on health care affordability and quality. s. On the same day, the Massachusetts Senate held a hearing for Senate Bill 867, which would establish a primary care spending target. More

    Publication

    Guide to Hospital Price Growth Targets

    May 2025
    Sarah Kinsler and Caitlin Otter
    This document describes the hospital-specific market basket methodology, which states can use to calculate hospital performance against the hospital price growth target. The Peterson-Milbank Program for Sustainable Health Care Costs funded the development of code that can be used to perform this analysis using state all-payer claims data. The document also includes key design and implementation considerations for states pursuing a hospital price growth target. More

    Publication

    The Corporate Backdoor to Medicine: How MSOs Are Reshaping Physician Practices

    April 2025
    Hayden Rooke-Ley, Megha Reddy, Neil Mehta, Yashaswini Singh and Erin C. Fuse Brown
    Private equity firms, insurance companies, and other corporate entities are using MSOs to bypass state prohibitions on the corporate practice of medicine, allowing large corporations to functionally own medical practices and influence clinical care. More

    Blog Post

    Engaging Employers in Addressing Health Care Affordability

    April 2025
    Alex Reger and Lisa Sementilli
    The Connecticut Office of Health Strategy is working toward engaging employers in the policy process. More

    Publication

    Bringing Balance to the Market: A Roadmap for Improving Health Insurance Affordability Through Rate Review

    February 2025
    Sabrina Corlette and Karen Davenport
    Unsustainable increases in health care costs are leading to high rates of medical debt, sapping the vitality of small businesses, straining state budgets, and dampening wage growth. States have the power to help reduce health care costs, and several are pursuing policies to do so. More

    Publication

    Lessons Learned from State Efforts to Slow and Shift Health Care Spending

    February 2025
    Robert Seifert, Emma Rourke and Mary Jo Condon
    This report describes the experiences of states that have designed and implemented policies to pursue these multiple targets and gathers lessons from their experiences to inform future policy development. Interviews with state officials and a multi-state convening revealed the strategies states used to establish their targets and their experiences implementing them. Officials described challenges to implementation and efforts to overcome them. More

    Publication

    A Menu of State Choices for Addressing Unaffordable Growth in Hospital Commercial Prices

    January 2025
    Anna Rothenberg and Michael Bailit
    This brief outlines seven potential strategies to address high and rapidly rising hospital prices, accompanied by examples from states that have successfully implemented these approaches. More

    Publication

    All About Rising Health Care Costs and What Legislators Can Do to Ease the Burden: Legislator Guides

    January 2025
    Christine Haran
    In a two-part primer for legislators, the Peterson-Milbank Program for Sustainable Health Care Costs explains health care cost trends and leading cost drivers, as well as state policies to track and slow health care spending. More

    Publication

    Pinpointing Performance: Improving Health Care Cost Growth Target Attribution Reporting for Providers

    December 2024
    Grace Flaherty
    State health care cost growth target programs aim to control health care spending by setting an annual goal for the maximum rate at which health care costs should increase that is tied to income and/or economic growth. In addition to reporting spending growth at the state, insurer market, and individual insurer levels, states with cost growth target programs report spending growth for large provider organizations, such as health systems and hospitals. Reporting on provider organization cost growth is an important strategy for keeping providers accountable for constraining spending growth. However, accurately attributing spending to these large provider entities can be challenging. More