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

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

    Read More

  • Health Care Affordability: Definitions and Options for States to Track Progress 

    Read More

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

    Read More

  • Resource Library

    Resource Types

    Current Topics

    States

    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

    News Article

    State Health Care Cost Growth Targets: Moving from Aspiration to Evidence to Action

    June 2025
    Mary Louise Gilburg
    In a new Health Affairs Forefront article, Milbank Memorial Fund president Christopher Koller discusses the role of health care cost growth target programs in spurring policy change to lower cost growth. More

    Blog Post

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

    June 2025
    Jessica Mar and Sarah Kinsler
    In 2024 and 2025, Bailit Health convened two work groups to establish consensus definitions and methodologies for health care spending analyses with support from the Peterson-Milbank Program for Sustainable Health Care Costs. More

    Publication

    State Approaches to Addressing Hospital Costs: Virtual Convening of Milbank State Leadership Network Recap

    June 2025
    Mary Louise Gilburg and Morgan McDonald
    The Milbank State Leadership Network hosted a virtual session for state legislators and legislative staff to discuss factors contributing to rising health care costs as well as opportunities for states to slow spending growth and make health care more affordable, with a particular focus on hospital costs. The briefing was hosted in partnership with Bailit Health, the technical assistance provider for the Peterson-Milbank Program for Sustainable Healthcare Costs. More

    Blog Post

    Health Care Affordability: Definitions and Options for States to Track Progress

    June 2025
    Grace Flaherty and Michael Bailit
    Health care affordability is a key concern for state agencies and policymakers looking to ensure access to care without creating undue financial burdens on patients, employer purchasers, and states. But affordability means different things to different stakeholders. For consumers, it might mean whether they can pay out-of-pocket costs without skipping care. For employers, it may mean health plan premium increases that don’t cut into their margins and/or reduce the ability offer competitive wages. For state officials, it might mean balancing the state budget by managing Medicaid and state employee health plan spending. More

    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