State Cost Growth Benchmark Programs and Total Medical Expenditures, 2010 to 2020

Are statewide cost-growth benchmark programs associated with reductions in per capita total medical expenditures growth?In this cohort study, a difference-in-differences analysis of 561 state-year observations found that cost-growth benchmark adoption was associated with a statistically significant 2.0% reduction in per capita spending growth. Reductions were concentrated in hospital and skilled nursing facility spending, with commensurate spending increases in home health care, and were observed in states with stronger regulatory or delivery system interventions.These findings suggest that state cost-growth benchmark programs may help modestly slow health care spending growth, particularly when paired with stronger accountability or payment reform mechanisms.

Corresponding Author: John N. Mafi, MD, MPH, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 1100 Glendon Ave, Ste 908, Los Angeles, CA 90024 (jmafi@mednet.ucla.edu).

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