The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
A bipartisan group of state health policymakers from both the executive and legislative branches who are focused on improving population health.
Networks of state officials, advocates, and others aiming to invest in and transform primary care.
A program dedicated to advancing state-based efforts to make health care more affordable for residents, employers, and states.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
A leadership development program for early and mid-career state government officials who are committed to improving the health of all people in their communities.
A leadership program for senior state government officials who are committed to improving population health.
The Fund focuses on creating an affordable health care system built on strong primary care and partnerships that improve health outcomes for all.
Improving state leaders’ ability to enact and implement evidence-based health policies.
Advancing policies that create a more prevention- and primary care-oriented health system.
Improving population health through policies that contain health care cost growth.
Our state health policy resources offer relevant data analysis and best practices.
The Fund publishes reports, issues briefs, and case studies on state health policy issues.
Short takes on health policy issues from Milbank staff and guest authors.
Insights from Milbank President Debra Lubar on state health policymaking.
Reported articles and Q&As on timely health policy issues, as well as foundation updates.
Milbank Memorial Fund and Milbank Quarterly webinars featuring state health policymakers and researchers.
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The Milbank Memorial Fund is a private foundation that works to improve population health and health equity.
November 11, 2025
Policy Report
Jessica Mar
Caitlin Otter
Michael Bailit
Publication
Oct 16, 2025
Sep 15, 2025
Aug 27, 2025
Over the last decade, high and rising health care costs have squeezed patients’ wallets, strained local economies, and consumed a growing share of state budgets. In response, states have increasingly recognized the urgency of addressing unsustainable health care cost growth through innovative cost containment strategies. A critical first step in this effort is to understand the cost drivers – the root causes of health care spending growth. The most effective way to identify cost drivers is by generating actionable insights from health care spending data.
In 2021, Peterson-Milbank published a guide for states on analyzing health care spending data from state All-Payer Claims Databases (APCDs). Since then, state agencies have made significant progress in building their capacity and expertise in this area. This updated resource incorporates lessons learned from that experience, offering enhanced recommendations for analyzing APCD data to produce meaningful insights that support data-driven communications and policymaking.
This document begins with an overview of best practices for conducting health care spending analyses, and then recommends specific cost driver analyses states should conduct to better understand where spending is high and growing. Where applicable, the analyses include examples – primarily from states, though some come from stakeholder coalitions – to demonstrate the types of insights these analyses can yield.
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