National Academy for State Health Policy Conference: States share innovative solutions to reducing healthcare costs
By Stephanie Jean-Louis
On August 15-17, 2018, Camden Coalition staff attended the 31st Annual Health Policy Conference, hosted by National Academy for State Health Policy (NASHP). NASHP is a nonpartisan forum of policymakers throughout state governments that uses communication and collaboration to solve problems, share learnings, conduct policy analyses and research, and provide technical assistance to states.
The conference, organized by state health policy makers, focused on emerging issues and current best practices for healthcare within states. With the Coalition’s focus on the New Jersey Medicaid population through our Good Care Collaborative, the NASHP conference was an ideal arena to learn how other states are innovating with Medicaid to treat their most complex patients.
A key emerging issue around the country is the rise in healthcare costs. The Thursday morning plenary session focused on the tangled web of payment, utilization, and policy that contribute to high costs in the United States. Speakers offered innovative solutions that could be implemented at the state level and highlighted a number of factors to consider when calculating rising costs. Some states have focused on reducing costly utilizations for their Medicare and Medicaid populations by redistributing dollars from fragmented health systems to coordinated care with social services. This redistribution is imperative for reducing redundancies in care, preventing unnecessary utilizations, and improving quality of care, especially for patients with complex health and social needs. However, utilization is not the only driver of costs.
When tackling healthcare costs, speakers at the NASHP Conference encouraged states to consider healthcare prices. In the United States, patients pay more for the same services compared to other developed countries. According to the Journal of the American Medical Association, a coronary artery bypass graft surgery costs an average of $75,345 in the U.S. compared to $15,742 in the Netherlands. Administrative costs, drug prices, and the fee-for-service payment model are some of the many factors that contribute to these high prices.
States have used creative solutions to address these cost factors. Jamie King, UC Hastings law professor and executive editor of The Source on Healthcare Price & Competition, noted the importance of data sharing for addressing high prices. Health information technology, like the technology used in the Camden Coalition Health Information Exchange, is pivotal to driving down costs because it helps to reduce administrative costs. Robust data sets are also key to driving innovations that improve quality for patients.
The American healthcare system’s fee-for-service model also adds to rising costs. Providers’ reimbursements are based on the cost of their services, so providers are incentivized to offer high priced services. In Ohio, a groundbreaking value-based payment model is looking to change these incentives. Speaker Greg Moody, who was the former director of Ohio’s Office of Health Transformation, spearheaded a value-based payment model that compares providers based on the cost and quality of their care. In this model of care, “providers are graded on how much it costs to provide high-quality comprehensive primary care and how much it costs to treat an episode of care such as an acute asthma episode.” Providers with high grades receive four dollar per patient per month bonuses, and providers with low grades receive bad reviews and no bonuses. This payment structure led to a drop in the cost of care for acute COPD and asthma episodes in Ohio. The model has also been effective for combating the opioid epidemic by analyzing how much providers prescribe opioids and grading providers who over-prescribe. This innovative payment model has been effective in reducing cost and improving quality for Ohioans.
The 2018 NASHP Conference facilitated important conversations about reducing healthcare costs and improving quality. Learning about best practices and innovations from different states can help local and regional organizations like the Camden Coalition work to control costs while improving care and bettering their patients’ wellbeing.
Stephanie Jean-Louis is the Special Assistant to the CEO at the Camden Coalition. Stephanie holds a Bachelors of Science in Biobehavioral Health from the Pennsylvania State University.
The next NASHP Health Policy Conference will take place on August 21-23, 2019 in Chicago, IL. For more information about the conference, visit https://nashp.org/.