Rhode Island Healthcare Cost Trends Project
A high-performing healthcare system must routinely assess the cost and quality of the care that patients receive and have robust, transparent data to support continual improvement. In the U.S., a lack of comprehensive, comparable data has created major gaps in our understanding of the price, utilization and quality of healthcare. After decades of sharply increasing costs, patients now pay significantly more for care and get considerably less from it than peers throughout the industrialized world.
In 2018, the Center launched the Rhode Island Healthcare Cost Trends Project with the State of Rhode Island and Brown University. The objective of this project was to analyze spending data to improve healthcare performance and provide assistance in setting a total healthcare cost growth target for Rhode Island. This collaboration established the groundwork for public reporting of state-wide healthcare spending and performance by engaging a Steering Committee of 17 stakeholders, including payers, providers, employers and community representatives, led by state and industry leaders.
Thanks to a strong collaboration from the Rhode Island healthcare community, the Steering Committee worked through the technical challenges of establishing a target for healthcare cost growth, assessing drivers of cost and identifying opportunities to lower cost of care growth. A notable outcome of the work was that Rhode Island Governor Gina Raimondo issued an Executive Order in early 2019 directing state staff to support the compact signed by stakeholders and the execution of the healthcare cost growth trend analysis. The order endorsed and memorialized the stakeholders’ commitment to achieve the target.
Through this work, our key learning was that active engagement in data and methodology enhances stakeholder trust and accountability for healthcare spend and performance. Healthcare decisions are made locally, so you must apply transparency in data analytics and its insights at a local level. Application of this information to purchaser and provider decisions requires a common understanding and goal among key stakeholders. It also requires trust in the insights that are generated and accountability for the results of the data. Trust and accountability are built not solely through goal alignment, but also through engaging key stakeholders in the development of methodological approaches and open assessment of data outputs.
In Rhode Island’s 2018 compact, all 17 members of the Steering Committee confidently took accountability for the proposed healthcare cost growth target and analytic approach to setting and monitoring the identified target. Methodological alignment and trust helped create data expansion and aggregation to progress relatively seamlessly.
Phase II of the project, which is currently underway, is focused on leveraging analytics and reporting to drive action on healthcare cost growth and performance in the state. The goal of this on-going cost trend work is to use actionable data insights, analytic tools, state authority and stakeholder engagement to drive meaningful reductions in healthcare spending growth in Rhode Island.
Peterson-Milbank Program for Sustainable Health Care Costs
The Peterson Center on Healthcare is working with the Milbank Memorial Fund to support efforts to set and track healthcare spending targets at the state level. The Peterson-Milbank Program for Sustainable Health Care Costs is working with five states, building upon similar successful efforts in Massachusetts, Rhode Island, Delaware and Oregon.
By increasing state capacity and capability in data and technology, the program will help participating states identify, establish and monitor key healthcare spending trends, and track them against agreed-upon targets. The work will build upon earlier efforts supported by the Center, and benefit from cross-state collaboration and learning among state officials and stakeholders.
To support these statewide efforts, the grant to the Milbank Memorial Fund provides working capital and technical assistance for innovative partnerships that manage real-world fiscal problems. The technical assistance, to be provided by the Milbank Memorial Fund and Bailit Health, includes experts who will collaborate with each participating state to develop and implement a work plan, facilitate stakeholder convenings and share experiences across states. The work will inform progress nationwide by developing implementation materials that all states can use to guide their cost growth initiatives.