Public Health

State Efforts to Control Healthcare Costs: Lessons Learned and Insights for the Future

May 29, 2024  • Health, Medicine & Society Program

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States have become laboratories for testing policy and programmatic ideas to address the high costs of healthcare and keep spending under control.A new report released by an expert Working Group offers a decisionmaking framework to guide them as they consider optimal approaches tailored to their needs.

The report draws on an Aspen Institute convening that brought together health policy experts in the public, private, nonprofit, and academic sectors. Their charge was to review statelevel experiences, identify learning and knowledge gaps, and summarize promising leverage points for advancing change, all with the goal of giving states fresh ideas for protecting their budgets and safeguarding the health of their residents. The work was informed by three commissioned papers that examined healthcare costs from three anglescompetition, regulation, and infrastructure.

Although state health systems differ considerably, the Working Group extracted several core elements relevant to all states: the need to build multi stakeholder coalitions, improve data systems and transparency, and respect the equity imperative. Members also agreed that some combination of competitionpromoting policies and regulatory changes will be necessary, that the appropriate balance between them will likely vary considerably across states, and that supportive infrastructure should be in place.

Working Group Participants


  • Jim Douglas, 80th Governor, State of Vermont (2003–2011)
  • Kathleen Sebelius, 21st Secretary, US Department of Health and Human Services (2009–2014), 44th Governor, State of Kansas (2003–2009)


  • Stuart Altman, Sol Chaikin Professor of National Health Policy, Brandeis University
  • Elisabeth Benjamin, Vice President of Health Initiatives, Community Service Society
  • Claire Brockbank, Director of Policy and Strategy, 32BJ Health Fund
  • Erin Fuse Brown, Professor of Law, Georgia State University College of Law
  • Eileen Cody, Former Member, House of Representatives State of Washington
  • Nancy-Ann DeParle, Managing Partner and Cofounder, Consonance Capital Partners Former Director; White House Office of Health Reform, Obama Administration
  • Andrew Dreyfus, Former President and CEO, Blue Cross Blue Shield of Massachusetts
  • Donna Kinzer, Principal, DK Healthcare Consulting; Former Executive Director, Maryland Health Services Cost Review Commission
  • Larry Levitt, Executive Vice President for Health Policy, KFF
  • Elizabeth Mitchell, President and CEO, Purchaser Business Group on Health
  • Kevin Patterson, CEO, Connect for Health Colorado
  • Caroline Pearson, Executive Director, Peterson Center on Healthcare
  • Zirui Song, Associate Professor, Health Care Policy and Medicine, Harvard Medical School
  • Emily Stewart, Executive Director, Community Catalyst
  • Mike Trachta, System Vice President, Rural Hospitals and Regional Operations MercyOne
  • Gail Wilensky, Senior Economist, Project Hope