peterson milbank

Peterson-Milbank Program for Sustainable Health Care Costs

The Peterson-Milbank Program for Sustainable Health Care Costs supports state-led efforts to make health care more affordable for everyone. Starting with setting a target for reasonable cost increases, states across the country are collecting data on their annual health care spending and analyzing it to find the cost growth drivers. With this information, everyone in the state who has a stake in health care can work together to identify community-wide solutions to improve affordability.

This program is a partnership between the Milbank Memorial Fund and the Peterson Center on Healthcare. Participating states include Connecticut, New Jersey, Oregon, Rhode Island, and Washington. See all state target values and latest performance reports.

  • "To even begin looking at what's happening in health care spending on a state level rather than national is an enormous accomplishment. Washington has different trends, different players, and a different landscape than other states. A state-specific look at the data is critical. "

    Emily Brice, JD

    Deputy Director, Northwest Health Law Advocates, Washington

  • "The health care cost growth benchmark is an important initiative. We have to be concerned with cost growth in health care because we need health care to be sustainable, affordable, and accessible without impacting quality. I believe that everyone feels they have a stake in that outcome, and that they can contribute to the goals of the initiative."

    Joanne Borduas, MSN, MBA

    Chief Executive Officer, Community Health and Wellness Center, Connecticut

  • "The cost growth benchmarking initiative has been thoughtful. I think they’ve tried to be very considered in their approach. They've gotten buy-in from both providers and payers and made it a collaborative effort. It is a step in the right direction."

    Al Charbonneau

    Executive Director, Rhode Island Business Group on Health

Highlights

  • How Payment Caps Can Reduce Hospital Prices and Spending: Lessons from the Oregon State Employee Plan

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  • The Power of Partnership: Utah's Approach to Affordable, Accessible, High-Quality Health Care 

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  • Video: A State-Led Approach to Improving the Affordability of Health Care

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  • Resource Library

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    Publication

    A Menu of State Choices for Addressing Unaffordable Growth in Hospital Commercial Prices

    January 2025
    Anna Rothenberg and Michael Bailit
    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

    Publication

    All About Rising Health Care Costs and What Legislators Can Do to Ease the Burden: Legislator Guides

    January 2025
    Christine Haran
    In a two-part primer for legislators, the Peterson-Milbank Program for Sustainable Health Care Costs explains health care cost trends and leading cost drivers, as well as state policies to track and slow health care spending. More

    Publication

    Pinpointing Performance: Improving Health Care Cost Growth Target Attribution Reporting for Providers

    December 2024
    Grace Flaherty
    State health care cost growth target programs aim to control health care spending by setting an annual goal for the maximum rate at which health care costs should increase that is tied to income and/or economic growth. In addition to reporting spending growth at the state, insurer market, and individual insurer levels, states with cost growth target programs report spending growth for large provider organizations, such as health systems and hospitals. Reporting on provider organization cost growth is an important strategy for keeping providers accountable for constraining spending growth. However, accurately attributing spending to these large provider entities can be challenging. More

    Publication

    Why Policies to Improve Health Care Affordability Are Important for Employers

    December 2024
    Christine Haran
    In this Peterson-Milbank Program for Sustainable Health Care Cost-sponsored video produced by the National Alliance of Healthcare Purchaser Coalitions, the Milbank Memorial Fund’s Rachel Block interviews Shawn Gremminger, President and CEO of the National Alliance of Healthcare Purchaser Coalitions, and Gloria Sachdev, President and CEO of the Employers’ Forum of Indiana about policies to lower […] More

    Blog Post

    Oregon’s Cost Growth Target: Balancing Payer and Health System Accountability with Flexibility

    November 2024
    Sarah Bartelmann
    The Oregon Health Authority (OHA) is implementing a mix of transparency, performance improvement plans, and financial penalties to ensure health plans and provider organizations take actions to meet the state’s target. More

    Blog Post

    Delaware Takes Bold Action to Improve Health Care Affordability

    October 2024
    Sarah Kinsler
    This spring, Delaware took a bold step to mitigate hospital spending growth. HB 350, signed into law in June, creates the Diamond State Hospital Cost Review Board, tasked with reviewing and regulating hospital budgets.  The new Review Board is designed to support Delaware in achieving the goals of its health care cost growth benchmark, which […] More

    Publication

    Not Just Squeezing the Balloon: A Comprehensive Set of State Strategies for Addressing Health Care Cost

    October 2024
    Elliott S. Fisher, Christopher F. Koller, Carrie H. Colla and Alena Berube
    Abstract  Health care is increasingly unaffordable in the United States. While comprehensive, affordable health coverage for middle- and low-income people is essential, the underlying problem is that US health care itself is too expensive.* High and rising health care costs harm families, employers, and state budgets. This brief expands on our New England Journal of Medicine  […] More

    Blog Post

    The Power of Partnership: Utah’s Approach to Affordable, Accessible, High-Quality Health Care

    September 2024
    Kelsey Koenen Witt
    Throughout the country, rising health care costs are constraining employer profits, decreasing employee wages, and crowding out other state spending needs. In 2022, Utah Gov. Spencer Cox prioritized the urgent need to address health care costs in his state, calling it an economic imperative.   Recognizing that true progress required collaboration, Cox appointed leaders from both the public […] More

    News Article

    Prescription Drugs Drove 2022 Spending in Cost Growth Target States

    August 2024
    Christine Haran
    An August 8, 2024, Health Affairs Forefront article by Jessica Mar and January Angeles of Bailit Health on trends in health care cost growth target states finds prescription drugs drove spending growth in Connecticut, Delaware, Massachusetts, Oregon, and Rhode Island — five of the eight states with health care cost growth target programs. Outpatient hospital […] More

    Publication

    How Payment Caps Can Reduce Hospital Prices and Spending: Lessons from the Oregon State Employee Plan

    July 2024
    Roslyn C. Murray, Christopher M. Whaley, Erin C. Fuse Brown and Andrew M. Ryan
    Policy Points Abstract The State of Oregon passed legislation in 2017 that prohibits hospitals from charging the state employee plan more than 200% of what Medicare pays for in-network hospital facility services and 185% for out-of-network prices. The law took effect starting in October 2019 and led to reductions in hospital services that generated more […] More