Publications

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

Many health providers are interested in making the shift to value-based payment (VBP), as these models can give greater flexibility in providing whole-person care, but administrative burden, variation in payer contracts, and a rapidly changing policy environment can impede their participation and success in these models. Streamlining the administration of payment models and adding supports like data sharing across payers and providers can make it easier for organizations by enabling more flexibility in care delivery, timely access to actionable information, and increased support for the health care workforce.  More

This brief identifies beliefs and common practices in health care culture that the authors suggest have hindered the spread of these models, as well as opportunities for the policymakers and influencers, payers, and clinicians to support whole-person health.   More

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

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

Policy Points States grappling with high and rising health care spending can draw inspiration from the Oregon State Employee Plan’s hospital…  More

States should consider six key activities to prioritize resources and use their authority most effectively.   More