Cross-Agency Strategies to Curb Health Care Costs: Leveraging State Purchasing Power
Rising health care costs are an intractable problem in the United States, but states, faced with balanced budget requirements and growing voter concern, aren’t waiting for a federal solution.
This report explores state initiatives to curb health care costs by:
- Leveraging Medicare’s well-established reimbursement rates as reference prices for state employee plans to address rising health costs;
- Harnessing collective buying power of state purchasers across agency and state lines to lower drug costs; and
- Establishing state authority to limit hospital rate increases, promote cost transparency, and limit spending growth.
States are increasingly looking beyond individual agencies and programs to harness the significant potential of their collective buying power.
State dollars fund Medicaid, state employee health plans, health services in mental health and correctional facilities, and public hospitals, and coverage for university, municipal, and school employees. When acting together, state agencies exert considerable buying power in an increasingly consolidated health care system. This report highlights the new wave of state initiatives that leverage collective purchasing clout to lower the cost trajectory.
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For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
