Third state adopts health care cost growth target

Greenbeard · Feb 10, 2019

Last week Rhode Island joined the small but growing club of states that have explicitly created a statewide goal for holding down health care cost growth.

Raimondo order creates target for limiting growth of health-care costs

Against this backdrop, Democrat Raimondo’s executive order establishes a “Rhode Island Health Care Cost Growth Target″ of 3.2 percent — over 2018 health care spending — for 2019 through 2022 “across all Rhode Island health care markets and populations.”

During that time, the executive order directs the state health insurance commissioner’s office and the super-agency known as the Executive Office of Health and Human Services to “engage relevant parties, including insurers, providers, and community partners, to develop strategies” to help meet the target, and “ensure that consumers and businesses purchasing health insurance share in the positive impact.”

The order also envisions further efforts by a previously created “Cost Growth Steering Committee to monitor and issue recommendations.”

It remains to be seen how much impact a governor can have on ballooning health-care costs, but it hinges on the stated belief that: “Enhanced transparency and shared accountability for a health care spending target can be used to accelerate changes in our health care delivery system, creating benefits for employers, state government, and Rhode Islanders.”

Massachusetts created its first-in-the-nation statewide benchmark for health spending growth six years ago; the latest data out of the state has been promising.

Massachusetts' total healthcare spending grew by 1.6% in 2017, falling well below the state benchmark and the national average, according to a new report.

The latest figures show Massachusetts' healthcare spending grew at nearly half the rate it did in 2015 and 2016 and well below the state's 3.6% cost growth benchmark, according to the Massachusetts Health Policy Commission's 2018 Cost Trends Report. The national average was close to 4% in 2017.

Total spending hikes in Massachusetts averaged 3.2% between 2012 and 2017, helping the state avoid $5.5 billion in projected additional spending, according to the report.

Delaware became the second state to set a target last year; its target for 2019 is higher than MA's and RI's.

Delaware Sets Health Care Spending Benchmark

NEW CASTLE, Del. – The Delaware Economic and Financial Advisory Council (DEFAC) on Wednesday issued a recommended Benchmark Index that set the state’s health care spending growth target at 3.8 percent for 2019 – the initial year of Delaware’s newly created Health Care Spending Benchmark. This move furthers the state’s goals of managing the growth of future health care spending, increasing transparency into how health care is delivered and paid for, and improving the quality and cost of health care for the citizens of Delaware.

DEFAC set the target based on Executive Order 25 signed by Governor John Carney in November. The order called for the initial benchmark to be equivalent to the advisory Benchmark Index for overall State budget growth established under Executive Order 21 signed by the Governor in June 2018.

We'll see what impact these moves have on focusing attention in Delaware and Rhode Island.

washunut · Feb 10, 2019

Greenbeard said:
Last week Rhode Island joined the small but growing club of states that have explicitly created a statewide goal for holding down health care cost growth.

Raimondo order creates target for limiting growth of health-care costs

Massachusetts created its first-in-the-nation statewide benchmark for health spending growth six years ago; the latest data out of the state has been promising.

Delaware became the second state to set a target last year; its target for 2019 is higher than MA's and RI's.

Delaware Sets Health Care Spending Benchmark

We'll see what impact these moves have on focusing attention in Delaware and Rhode Island.

More importantly we will see what actions they take to accomplish this. y sense if bringing down costs is very doable without attacking the boogieman usual suspects. Doubt politicians have the ability to take common sense action.

Hawkeye10 · Feb 10, 2019

washunut said:
More importantly we will see what actions they take to accomplish this. y sense if bringing down costs is very doable without attacking the boogieman usual suspects. Doubt politicians have the ability to take common sense action.

Rationing care is essential.

SDET · Feb 10, 2019

Greenbeard said:
Last week Rhode Island joined the small but growing club of states that have explicitly created a statewide goal for holding down health care cost growth.

Raimondo order creates target for limiting growth of health-care costs

Massachusetts created its first-in-the-nation statewide benchmark for health spending growth six years ago; the latest data out of the state has been promising.

Delaware became the second state to set a target last year; its target for 2019 is higher than MA's and RI's.

Delaware Sets Health Care Spending Benchmark

We'll see what impact these moves have on focusing attention in Delaware and Rhode Island.

Health insurance prices remain high in those states because of mandated coverages such as maternity.

Greenbeard · Feb 10, 2019

washunut said:
More importantly we will see what actions they take to accomplish this. y sense if bringing down costs is very doable without attacking the boogieman usual suspects. Doubt politicians have the ability to take common sense action.

For Rhode Island at least, like Mass, they're already on a path. Working toward revamping the incentives underpinning their system, rethinking how care delivery is organized, scrutinizing provider price increases and insurance premium hikes. (In some ways they may be about to take on one of the Massachusetts health care system's problems, though, as the largest and highest-priced provider system in Massachusetts is currently in the process of buying the second-largest provider system in Rhode Island--that's a development to watch.)

I suspect the adoption of a statewide target in Rhode Island is less about jumpstarting anything and more about re-focusing the major stakeholders in the state.

SDET said:
Health insurance prices remain high in those states because of mandated coverages such as maternity.

Maternity coverage has been mandatory for all fully insured health plans in the U.S. for the past half decade. More importantly, however, the majority of privately insured people are in self-insured plans, which aren't subject to benefit mandates.

washunut · Feb 10, 2019

Greenbeard said:
For Rhode Island at least, like Mass, they're already on a path. Working toward revamping the incentives underpinning their system, rethinking how care delivery is organized, scrutinizing provider price increases and insurance premium hikes. (In some ways they may be about to take on one of the Massachusetts health care system's problems, though, as the largest and highest-priced provider system in Massachusetts is currently in the process of buying the second-largest provider system in Rhode Island--that's a development to watch.)

I suspect the adoption of a statewide target in Rhode Island is less about jumpstarting anything and more about re-focusing the major stakeholders in the state.

Maternity coverage has been mandatory for all fully insured health plans in the U.S. for the past half decade. More importantly, however, the majority of privately insured people are in self-insured plans, which aren't subject to benefit mandates.

Personally I would like to take real steps to reducing costs rather than beating people over price hikes. For example finding our how to increase utilization rates of expensive diagnostic equipment. How to reward people for losing weight,paying for gym memberships etc. How to rely on home care versus hospital care. Yes I will say not approving a medicine that costs $300K which might add 3 months to someone's life.

Greenbeard · Feb 11, 2019

washunut said:
Personally I would like to take real steps to reducing costs rather than beating people over price hikes. For example finding our how to increase utilization rates of expensive diagnostic equipment. How to reward people for losing weight,paying for gym memberships etc. How to rely on home care versus hospital care. Yes I will say not approving a medicine that costs $300K which might add 3 months to someone's life.

That's what changing the incentives underpinning the health system is about. If providers can make money by using resources more efficiently and cutting costs rather than the reverse, then eliminating unnecessary utilization and directing patients to the lowest cost appropriate care setting becomes part of the business model and thus part of the care delivery model.

marke · Feb 11, 2019

Greenbeard said:
Last week Rhode Island joined the small but growing club of states that have explicitly created a statewide goal for holding down health care cost growth.

Raimondo order creates target for limiting growth of health-care costs

Massachusetts created its first-in-the-nation statewide benchmark for health spending growth six years ago; the latest data out of the state has been promising.

Delaware became the second state to set a target last year; its target for 2019 is higher than MA's and RI's.

Delaware Sets Health Care Spending Benchmark

We'll see what impact these moves have on focusing attention in Delaware and Rhode Island.

States are putting caps on healthcare spending? Is that like the caps on the federal debt that democrats kept wanting to abolish during the Obama years? Good. I am glad to see the discussion about universal healthcare has finally turned to the explosive costs associated with free government care.

washunut · Feb 11, 2019

Greenbeard said:
That's what changing the incentives underpinning the health system is about. If providers can make money by using resources more efficiently and cutting costs rather than the reverse, then eliminating unnecessary utilization and directing patients to the lowest cost appropriate care setting becomes part of the business model and thus part of the care delivery model.

I am in favor of all of those sort of changes, which are sorely needed.

Obscurity · Feb 11, 2019

SDET said:
Health insurance prices remain high in those states because of mandated coverages such as maternity.

So you want maternity to not be covered by insurance?

SDET · Feb 11, 2019

Obscurity said:
So you want maternity to not be covered by insurance?

I sure as hell don't need it.

Obscurity · Feb 12, 2019

SDET said:
I sure as hell don't need it.

And? Who gives a **** about you. There are how many women in this country?

SDET · Feb 12, 2019

Obscurity said:
And? Who gives a **** about you. There are how many women in this country?

And you hit the nail on the head regarding feminism. Extract money from men and give it to women. There's no good reason to mandate maternity coverage.

Obscurity · Feb 12, 2019

SDET said:
And you hit the nail on the head regarding feminism. Extract money from men and give it to women. There's no good reason to mandate maternity coverage.

Yes, there is. It's a requirement for the rest of society to grow and proliferate.

I agree as a man you should not have maternity coverage.

I am no feminist, but I am also not an extremist like you are.

RobertU · Feb 12, 2019

SDET said:
And you hit the nail on the head regarding feminism. Extract money from men and give it to women. There's no good reason to mandate maternity coverage.

So, you would also eliminate coverage for prostate or testicular cancer? Only men need that. Why should women pay for it?

marke · Feb 12, 2019

Greenbeard said:
Last week Rhode Island joined the small but growing club of states that have explicitly created a statewide goal for holding down health care cost growth.

Raimondo order creates target for limiting growth of health-care costs

Massachusetts created its first-in-the-nation statewide benchmark for health spending growth six years ago; the latest data out of the state has been promising.

Delaware became the second state to set a target last year; its target for 2019 is higher than MA's and RI's.

Delaware Sets Health Care Spending Benchmark
We'll see what impact these moves have on focusing attention in Delaware and Rhode Island.

It is a good thing states are beginning to wake up to the reality that the government cannot keep providing services they cannot afford.

SDET · Feb 12, 2019

RobertU said:
So, you would also eliminate coverage for prostate or testicular cancer? Only men need that. Why should women pay for it?

They are called optional riders, priced in accordance to the financial risk involved. They make insurance more affordable.

Greenbeard · Feb 13, 2019

SDET said:
And you hit the nail on the head regarding feminism. Extract money from men and give it to women. There's no good reason to mandate maternity coverage.

Sure there is. First of all, the argument that men shouldn't pay for maternity care shouldn't be made by anyone old enough to know where babies come from and what role men have in the process.

As a practical matter, birth is by far the most common condition driving hospitalizations in the U.S. So how to finance this very common procedure that plays such an important role in our health care system? We could tack on less than $300/year to each nongroup policy, or tack on ~$14,000/year to just pregnant women. Tough call on which approach makes more fiscal sense!

Regardless, again, differences in mandatory maternity coverage do not explain differences in costs across states because (1) maternity has been mandatory in all fully insured coverage nationwide for half a decade, and (2) most people are in self-insured plans which aren't subject to benefit mandates.

Third state adopts health care cost growth target

Buttermilk Man