Some state-level efforts to reduce healthcare costs without sacrificing quality are working and should be replicated by others states, especially because local government is more poised to make changes than the federal government, according to a report released Monday.
The Center for American Progress (PDF) studied successful state initiatives like bundled payments, all-payer claims databases and cost-growth goals. The authors say states are in the best position to try these methods because reform is more politically feasible and programs can be tailored to a state's specific demographics.
The state's programs have common themes of improving care coordination, collecting more data and making that data more transparent. That allows states to focus on paying for quality over quantity.
One of the most cited states is Maryland, which is the only state to have developed a global budget for hospitals. Under the system, the state determines a budget for each hospital based on previous and projected expenditures and performance.
The move in 2014 has slowed hospital spending growth and lowered inpatients admissions and Medicare readmission rates. Other states could replicate the effort with smaller pilot programs and grant incentives for participating hospitals, according to the report.
Other suggestions include many common sense measures such as combatting drug addiction, expanding telehealth services, integrating behavioral health services and improving the delivery of long-term care.
The report also recommends more home-based services for young children and the elderly. Nurse visitation programs can help parents create a healthy family environment and often pay for themselves. States should also look to re-balancing long-term-care efforts toward home- and community-based services.
