A new report from the Center for American Progress (CAP) outlines how states are well-positioned to be leaders in implementing policies to help control healthcare costs and improve quality. 

Many of the reforms available to states—such as setting a healthcare cost growth goal or establishing a statewide scorecard—can be accomplished at little to no cost but are capable of making a big impact. Others, such as scaling evidence-based home visiting statewide, require upfront investments but then pay for themselves in future cost savings. 

States are natural leaders in this space, according to CAP, since they have considerable authority over the regulation of health insurance and the provision of healthcare within their borders.

The recent debate on healthcare reform has occurred mostly at the national level. The Affordable Care Act (ACA) was a momentous change for the U.S. healthcare system, with 20 million people having gained health insurance coverage due to the law.

“The current political environment makes it unlikely that reforms to control system-wide health care costs will be achieved at the federal level in the near future,” writes Zeke Emanuel, senior fellow at CAP. “States, however, are well-positioned to take the lead on implementing cost control and quality improvement reforms”.

As CAP notes in the report, a number of states are already innovating in this area and seeing positive results for local government, providers, payers, and consumers. Maryland and Massachusetts are among the state leaders in setting forth cost control reforms, but they are not alone in improving the quality and sustainability of their healthcare systems. 

With healthcare costs projected to grow faster than the overall economy, CAP’s report details how nearly two dozen other states are undertaking efforts to alleviate this pressure on their budgets and services.

The report includes a comprehensive summary of options for state governments to slow the growth of health care costs, improve the quality of their health care systems, and protect their residents. 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. Examples included establishing a cost growth goal, launching all-payer claims databases, integrating behavioral health and primary care, and to expand the use of telehealth.