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. This support includes direct technical assistance to individual states in analyzing and addressing the underlying drivers of health care cost growth, regular opportunities for peer networking, as well as the facilitation of cross-state projects on shared affordability priorities.

This program is a partnership between the Milbank Memorial Fund and the Peterson Center on Healthcare. Participating states include ConnecticutMinnesota, New JerseyOregonRhode Island, Utah, and Washington.

What are cost growth targets?

Cost growth targets, or benchmarks, 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.

See target values and performance reports

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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

  • Separating the Haves from the Have-Nots: State Options for Targeted Application of Hospital Affordability Policies 

    Read More

  • Assessing Hospital Efficiency: Considerations for States Seeking to Reduce Health Care Costs

    Read More

  • Standardized Health Spending Analytic Definitions and Methods: Cross-State Collaboration Leads to Stronger Results

    Read More

  • Resource Library

    Resource Types

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    Locations

    Blog Post

    Ensuring State Health Care Affordability Strategies Work for All

    October 2025
    Erin Taylor and Matthew Reynolds
    This post describes ways states can safeguard and promote health equity alongside their efforts to make health care more affordable, particularly for those who bear the greatest burden of high and rising health care costs. The post identifies four overarching approaches states can take. More

    Publication

    Rethinking Hospital Efficiency — from Ratios to Public Trust

    October 2025
    Thom Walsh
    Our experience in Vermont highlights both the strengths and the limitations of evaluating efficiency using standard measures of expenses and revenue. More

    Publication

    Separating the Haves from the Have-Nots: State Options for Targeted Application of Hospital Affordability Policies

    September 2025
    Sarah Kinsler
    Abstract As states seek to tackle high commercial health care spending, high spending growth, and increasingly unaffordable care, they must consider hospital spending and prices as major contributors. In many states, policy discussions have been stymied by hospitals and their lobbyists, who argue that hospitals are struggling financially and that state action to address hospital […] More

    Publication

    Rhode Island’s Health Care Affordability Standards: Lessons for Other States Seeking to Control Health Care Spending

    September 2025
    Nathan Hostert and Andrew M. Ryan
    A recent study finds that Rhode Island’s affordability standards, which apply only to the fully insured market, have led to a 9% relative reduction in hospital prices across the entire commercial market. More

    News Article

    State Health Care Spending Growth Trends Point to Need for Policy Action

    September 2025
    Christine Haran
    The third annual analysis of spending growth trends across cost growth target states finds all five exceeded their targets. More

    Publication

    How States Strengthened Their Health Care Markets in the 2025 Legislative Session

    August 2025
    Nathan Hostert
    In the first half of 2025, states enacted numerous laws to strengthen their health care markets. These new laws address several recurring policy issues affecting states across the country, including skyrocketing health care costs, increased consolidation in the healthcare sector, and the heightened penetration of private equity in health care systems. This brief highlights trends in state health policy across four major themes and identifies states that have made significant reforms in each of these areas this year. More

    Blog Post

    Focus on Affordability: State Strategies for Responding to Federal Policy Changes

    August 2025
    Rachel Block
    The passage of HR1/OBBB, the 2025 budget reconciliation law, is expected to lead to the loss of coverage for  16 million Americans, lower revenue for health systems, and add administrative burden to states. There are a few ways that states can try to minimize these harms. More

    Publication

    Assessing Hospital Efficiency: Considerations for States Seeking to Reduce Health Care Costs

    July 2025
    Alyssa Vangeli and Sarah Kinsler
    This brief provides an overview of existing state, federal, and private sector hospital efficiency measures; the advantages and limitations of those measures; potential modifications to existing measures; and options for how states can employ new or existing measures to better understand current hospital efficiency levels and incentivize improved efficiency. More

    Publication

    Consensus Administrative Specifications for Health Care Cost Analyses

    June 2025
    Christine Haran
    Download consensus definitions and methodologies for health care cost driver analyses and cost growth target programs. More

    Publication

    Beyond Public Reporting: Strengthening Accountability to States’ Cost Growth Targets and Leveraging Targets in Health Care Oversight

    June 2025
    Grace Flaherty and January Angeles
    This issue brief examines how three of these states —Massachusetts, Oregon, and California — have strengthened cost growth target accountability. It also highlights five states — California, Connecticut, Delaware, Massachusetts, and Oregon — that have leveraged their cost growth targets in other health care oversight programs. More