While health costs have moderated recently, most experts expect costs to begin rising faster than inflation into the future. As states are powerful health care purchasers, this is a significant strain on budgets. There is also a growing consensus that we are not getting the quality we are paying for. However, a new Health Affairs blog points out that states are also in a powerful position to innovate and find solutions. States have significant regulatory authority over health care including insurance rate setting, provider certification, and convening power, which may be the most salient lever in the currently fragmented system. States can structure reforms to match local circumstances. With flexibility not available to federal regulators, states are leading innovators in cost control and quality improvement. The authors list fifteen options available to states including publishing a scorecard, adopting payment and delivery system reform goals, test alternative payment models, build an All-Payer Database, integrate behavioral health and primary care, adopt evidence-based options, adjust scope of practice regulations, expand telehealth, and decrease unnecessary emergency room use. Many of these ideas have been highlighted elsewhere, including CSG-ERC’s Value Over Volume 2.0 report.
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