State Reports

• Massachusetts’ HPC released its 2021 Annual Cost Trends Report, which examines the state’s cost growth trends in 2019 and includes five overarching policy recommendations for lawmakers, providers, payers, employers, and other health care market participants to create a more affordable and accessible high-quality health care system. These recommendations include key actions for the state to take to address the intersecting challenges of cost containment, affordability, and health equity.
• In June, Connecticut updated the figures within its Healthcare Affordability Index (CHAI) to reflect new, temporary premium subsidies enacted in the American Rescue Plan Act (ARPA) enacted in March 2021, and additional state subsidies enacted by the state budget in June 2021. The CHAI measures the impact of health care costs, including premiums and OOP expenses, on a household’s ability to afford all basic needs. Following the passage of temporary ARPA subsidies, the CHAI estimated an additional 35,000 Connecticut households would see improved health care affordability; additionally, the new state subsidies were estimated to provide additional assistance to another 40,000 people in the state.

Additional Reports Relating to Health Affordability and Cost Containment

• Reducing Health Care Spending: What Tools Can States Leverage? (The Commonwealth Fund, August 18, 2021). The Commonwealth Fund’s latest issue brief examines the range of strategies available to states to address rising health care costs, including promoting competition, reducing prices through regulation, designing incentives to reduce the utilization of low-value care, and broader, systemwide policies such as imposing spending targets and promoting payment reform. Recognizing that different states are likely to take varying approaches to address this issue, the brief articulates the value of health policy commissions in particular in advancing reform by supporting initiatives of existing state agencies or by directly implementing new policies themselves.
• A Data Use Strategy for State Action to Address Health Care Cost Growth (Milbank Memorial Fund, June 24, 2021). States with health care cost growth targets conduct two types of analyses on collected payer and provider data: (1) routine standardized analyses to monitor the impact of the cost growth target; and (2) in-depth, ad hoc analyses of potential drivers of high costs, cost variation, and cost growth identified from routine reports, potentially using other data resources to do so. The latest brief from the Milbank Memorial Fund discusses the design of the first category of analysis, providing an analytic framework that asks, “Where is spending problematic? What is causing the problem? And who is accountable?” The report also outlines a series of 11 recommended standard reports that apply the framework to state cost growth analyses.
• State Benchmarking Models: Promising Practices to Understand and Address Health Care Cost Growth (Manatt Health, June 17, 2021). As state cost growth benchmarking models continue to develop and evolve, Manatt Health examines how states are shaping their programs, how they are supporting health care cost transparency, and other emerging data use cases, including identifying trends in patient cost-sharing and driving investments in primary care. This report also identifies opportunities for standardization in data collection and analysis as more states continue to establish cost growth benchmarking programs.