Total Cost of Care

Several states have adopted policies that focus on measuring and setting a growth rate target for total cost of care. By looking at the cost performance across all payers of the system as a whole or a particular set of services such as hospital care, these states hope to facilitate delivery system reform.

At the request of several states, the Fund launched a project in 2015 to assess and document methods that states use to set a rate of growth target for total cost of care measures. The Fund’s initial report looks at four states as models for this activity—and assesses how they are going about this work. How are they documenting costs, projecting growth rates, and setting targets?

In addition to tracking the original states’ work, additional states are developing policies and technical capacity for health care cost measurement. The Fund continues to facilitate state-to-state interaction on this topic to enhance collaborative learning for both the states involved in the project and others states considering this policy activity.

Another focus for the Fund is developing and supporting the use of measures for primary care spending.  These measures will strengthen the evidence base for primary care, and inform national and state policy activities. The Fund will continue to work with policymakers and stakeholders to advance this work.

Total Cost of Care News

  • Building Momentum to Measure Primary Care Spending

    Feb 28, 2018

    How much of our health care dollars actually go toward supporting primary care, which is consistently acknowledged to be key to improving population health?  Some states are working toward an answer. “At the Fund, we are working to increase policy focus on primary care spending,” said Rachel Block, Fund program officer. “It’s a good measure of how oriented a health system is to … Read more

  • Announcing the Milbank Memorial Fund and AcademyHealth State and Local Innovation Prize

    Jan 25, 2018

    The Milbank Memorial Fund has teamed up with AcademyHealth to establish a new annual award that recognizes state and local efforts to advance innovation using data to improve the health of populations and the performance of health systems. The prize was created to draw attention to, and reward, the efforts of state and local governments to develop and use data to achieve measurable … Read more

  • Comparing and Monitoring State Health Care Spending Trends

    Oct 31, 2017

    We have heard a lot about health care costs lately—and state health leaders and the public have many questions about them. Does my state spend more on health care than others? How much does spending vary based on who is paying? How has that spending changed over time and why? Measurement activities continue at both the national and state level. Here are two recent updates: Comparing … Read more