Healthcare Value State Accountability and Oversight

Resources

It’s hard to imagine robust progress on healthcare value issues without an overarching entity whose role is to look at the big picture. And yet, to date, only a few states have a centralized oversight agency that focuses on reducing healthcare costs, improving quality, bringing spending in line with overall economic growth and implementing new innovations for better value.

States play a critical role in how the health system functions, but too few states take a coordinated, systematic approach to ensuring that consumers get value for the money they spend. All states regulate some parts of their healthcare systems, but many lack a comprehensive, inter-agency, multi-payer plan to address this enormous segment of their economy and top concern of residents and employers.

Many resources address the critical federal role in the provision of a fair, efficient health system. Below we assemble resources that specifically focus on the state role.

States Have a Unique Role in Getting to Healthcare Value

Our fragmented health system typically limits the ability of any one payer or stakeholder to incentivize the provider practice changes that will lead to lower costs. States are well positioned to:

• Serve as a convener
• Support multi-payer coordination
• Invest in "upstream" approaches that lead to healthier communities

Broad access to coverage and getting to better healthcare value are inseparable, intertwined policy objectives.

Why We Need State Accountability

• State Roles in Delivery System Reform, National Governors Association (2010). 

• Convening Report, State Accountability for Healthcare: A Report from a Convening of Healthcare Experts Healthcare Value Hub (March 2017)

• “Statewide Payment and Delivery Reform: Do States Have What It Takes,” Journal of Health Politics, Policy and Law (forthcoming)

• Pew State Health Care Spending Project

• Social and Healthcare Spending – Health Affairs, RWJF

• Enlisting States as Partners in Healthcare Cost Savings (2014).

Proof of Concept

• Healthcare Stewardship Case Studies for Colorado, Ohio, Oregon, Minnesota, and Vermont (Urban Institute)

• Lessons from High- and Low- Performing States for Raising Overall Health Systems Performance - The Commonwealth Fund (2011). 

• Measuring Healthcare Value at the State Level: A Call to Action, Research Brief No. 15, Healthcare Value Hub (December 2016) - “proof of concept” examples from CA, CO, FL, ME, MA, MD, MN, NY, OR, PA, VA, VT, and WA.

• Ohio 2017 Health Value Dashboard

• CT Office of Health Strategy Legislation

• For case studies of multi-payer initiatives in Arkansas, Minnesota, Oregon and Vermont, see: All Aboard: Engaging Self-Insured Employers in Multi-Payer Reform, Milbank Memorial Fund (2015).

Implementation Aids

• State Strategies for Leveragng Purchasing Power, National Governors Association (2015).

• Buying Value Tool Kit - Robert Wood Johnson Foundation

• Total Cost of Care – Network for Regional Healthcare Improvement—a pilot to measure and report Total Cost of Care and Relative Resource Use by region

Scorecards Examining State Performance

• Price Transparency Report Card (Health Care Cost Institute and Catalyst for Payment Reform)

• Health System Performance Scorecards, Commonwealth Fund

• Healthways Well-being Survey

• RWJF County Rankings