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URL: https://fsi.stanford.edu/news/rhode-island-adopts-regulations-slow-health-care-costs-—-and-they-work
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Title: FSI - Rhode Island adopts regulations to slow health-care costs — and they appear to work
Description: As the price of health care in the United States continues to accelerate — to the consternation of both patients and providers — it’s refreshing to find one state pilot project that appears to prove that implementing mandatory price controls can actually work.
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Texto: FSI - Rhode Island adopts regulations to slow health-care costs — and they appear to work Skip to: Skip to content Skip to navigation Stanford University Search form Research Education People Centers News Events About Research Education People Centers News Events About Search form < All FSI News February 4, 2019 Rhode Island adopts regulations to slow health-care costs — and they appear to work Beth Duff-Brown gettyimages-healthcare_coins.jpg Photo credit:  Getty Images As the price of health care in the United States continues to accelerate — to the consternation of both patients and providers — it’s refreshing to find one state pilot project that appears to prove that implementing mandatory price controls can actually work. Some states are keen to adopt regulations to slow health-care spending growth, but few have done so, therefore little is known about whether price controls could truly bring costs down. So Stanford Health Policy’s Sanjay Basu  and colleagues at Harvard and Brigham and Women’s Hospital set out to investigate the first such program. Rhode Island adopted affordability standards in 2010 that imposed price controls — particularly inflation caps and diagnosis-based payments — on contracts between commercial insurers and hospitals and clinics. It also required those commercial insurers to increase their own spending on primary care coordination services, which help ensure a patient's caregivers are working together efficienty. The results were quite promising. The researchers compared spending among 38,000 commercially insured adults in Rhode Island to the spending of 38,000 matched adults in other states from 2007 to 2016.  Their results , just published in Health Affairs, show that fee-for-service spending among the Rhode Island group — in comparison with out-of-state health care enrollees, decreased by $76 per enrollee after implementation of the policy, or a decline of 8.1 percent from 2009 spending. By contrast, the primary care coordination spending (not fee-for-service) went up by $21 per enrollee, which is good, Basu noted, because those services are designed to prevent more costly medical needs such as emergency department visits.  “It is extremely rare to see a health-care intervention that actually slows the growth in spending,” said Basu, a primary care physician and epidemiologist. “Most people talk about controlling spending, and none of the interventions address the fundamental problem: the inflation in prices of health-care services.” Basu, an assistant professor of medicine, said the researchers found that total spending growth decreased, driven by lower prices concurrent with the adoption of price controls. “The Rhode Island experience indicates that states can slow total commercial health-care spending growth through price controls while maintaining quality,” the authors wrote. “The standards provide an important policy test of a bold, large-scale, multi-payer reform coordinated by a state government to reduce the growth in commercial-sector health care spending.” The Rhode Island’s Office of the Health Insurance Commissioner implemented the set of affordability standards in 2010 for all commercial insurance companies in the state. Chief among the price controls were:  Capping the annual price inflation equal to the Medicare price index, plus 1 percentage point for both inpatient and outpatient services; Transitioning hospital payments from per-diem to value-based payments based on outcomes — such as how many patients avoid infection after a surgery — and those based on diagnosis-related groups; And increasing the share of spending on primary care services by 1 percentage point per year from 2010 to 2014 without raising consumer premiums. “We importantly did not see a decline in care quality, which may be due to improved primary care and more avoidance of emergency rooms and hospitals in favor of preventive and coordinated outpatient healthcare, which is often cheaper,” Basu said. The researchers believe the results of their evaluation “have important implications for policymakers seeking to slow the growth in health-care spending. “State regulators in Rhode Island achieved among the largest total health-care spending changes observed from payments reforms to date,” they wrote. Topics: Health Care | Health care institutions | Health Care Reform | Health Outcomes | Health policy Share this News Recent FSI News Winners announced for the Fall 2018 Stanford e-Japan Award Thurber: Why it's difficult to reduce gas flaring Honoring Stanford e-Tottori students North Korea in 2018: A Q&A with Siegfried Hecker Podcast: Elizabeth Economy on Xi Jinping’s Third Revolution and the Future of U.S.-China Relations Podcast: Donald K. Emmerson on How Southeast Asian Nations Balance China-U.S. Relations China Program Convenes Leading Scholars to Discuss the Field of Chinese Politics in the Era of Xi Jinping and to Chart Its Future PODCAST: Jaw-Jaw: How Chinese Sharp Power Takes Aim at American Democracy All FSI News Our Address Encina Hall616 Serra St C100Stanford UniversityStanford, CA 94305-6055 Navigate Research Education People Centers News Events About Follow Us General inquiries 650-723-4581 Mail Twitter   Support Us Learn more about how your support makes a difference or make a gift now Make a gift   Top Stanford Home Maps & Directions Search Stanford Emergency Info Terms of Use Privacy Copyright Trademarks Non-Discrimination Accessibility © Stanford University , Stanford , California 94305 . Copyright Complaints


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