States improve quality, reduce costs via reform

States that have implemented health reform options have reduced costs while also maintaining or even improving the quality of care, reports HealthAffairs.

Implementation of the Affordable Care Act has had a significant change on the nation's healthcare system. A total of 20 million people have gained health insurance. Also, thanks in part to the creation of the Center for Medicare and Medicaid Innovation, the growth of healthcare spending has slowed in recent years.

Healthcare spending still puts stress on state and federal budgets, which in turn limits spending on other programs. However, states that are implementing cost control and qualify improvement reforms best tailored to each state have shown positive results.

By controlling their own insurance markets, states are able to run their Medicaid and state employee plans, while controlling the rate review process, scope-of-practice regulations, physician licensing, antitrust laws and provider and insurer regulations.

“The innovations that some states are implementing to reduce costs while maintaining or improving quality can and should be replicated by other states,” said Zeke Emanuel, Senior Fellow at the Center for American Progress, and colleagues in the report. “Generally, these options relate to implementing new payment models, increasing accountability and transparency, collecting more data, increasing the use of high-value services and practices, and removing barriers to effective practices.”

Reform options that would assist states in slowing the growth of healthcare spending wihle improving the quality of care to its citizens include: 

• Establishing a cost growth goal;
• Publishing a health and cost outcomes scorecard;
• Adopting payment and delivery system reform goals;
• Implementing bundled payments for all payers;
• Instituting global budgets for hospitals;
• Launching all-payer claims databases;
• Expanding evidence-based home visiting services;
• Improving price transparency;
• Integrating behavioral health and primary care;
• Combatting addiction to prescription drugs and heroin;
• Improving the delivery of long-term care;
• Aligning scope of practice with community needs;
• Instituting reference pricing in the state employee plan;
• Expanding the use of telehealth;
• Decreasing unnecessary emergency room use.