Publications

Unsustainable increases in health care costs are leading to high rates of medical debt, sapping the vitality of small businesses, straining state budgets, and dampening wage growth. States have the power to help reduce health care costs, and several are pursuing policies to do so.   More

This 2025 Primary Care Scorecard spotlights the downward cycle of financing for primary care, describing how persistent challenges in primary care arise from insufficient investment (or in the case of training, misplaced investment) and a fee-for-service (FFS) payment model that rewards volume rather than continuous, whole-person care. This report highlights how these systemic financial issues not only undermine the effectiveness of primary care delivery but, more importantly, jeopardize the overall health of our communities in the following ways.  More

This report describes the experiences of states that have designed and implemented policies to pursue these multiple targets and gathers lessons from their experiences to inform future policy development. Interviews with state officials and a multi-state convening revealed the strategies states used to establish their targets and their experiences implementing them. Officials described challenges to implementation and efforts to overcome them.  More

This brief outlines seven potential strategies to address high and rapidly rising hospital prices, accompanied by examples from states that have successfully implemented these approaches.  More

Community health workers, promotores, and community health representatives have historically relied on a patchwork of grants for funding, but more than half of state Medicaid programs have now implemented some form of CHW/P/CHR coverage and payment policy. This toolkit provides model language for state Medicaid leaders and CHW/P/CHR advocates to use as they develop State Plan Amendments and accompanying guidance documents to establish coverage and payment for CHW/P/CHR services.  More