Governors discuss ways to cut health care costs at state level
State leaders examine past lessons, current resources
Leaders talk about ways to handle high cost of chronic health problems, providing follow-up care while keeping costs low.
WILLIAMSBURG, Va. — With states divided along party lines when it comes to implementing the Affordable Care Act, governors meeting here over the weekend tried to look beyond politics to how to cut health care costs.
Unlike the bitter battle at the national level, they calmly found middle ground by sticking with issues that can be addressed at the state level.
“Fifteen years ago, we thought we would never, ever get a handle on violent crime,” said Gov. Martin O’Malley, D-Md., and he then talked about innovative ideas that worked in that arena, such as performance reviews and incentives. “I’m hearing all the same ideas. I’ve seen what you all are doing. It sounds like what we need is a common platform.”
Experts in health care talked about handling the high cost of chronic health issues for patients, keeping track of patients who needed follow-up care to keep them healthy and cut costs, and creating incentives for providers that lower costs for the states. Some lessons seemed obvious. Savings could be achieved by addressing cases such as the Medicaid dental patients in Minnesota who went to the hospital for pain medication, rather than to a dentist for treatment, or the health care providers at 11 centers who duplicated medical tests because there was no incentive to stop, said Jennifer DeCubellis, director of Hennepin County Health in Minnesota.
Many states are already working through solutions included in the Affordable Care Act, by making providers work together as a team, improving medication management, and better information sharing between health care systems, including with electronic records.
Some officials at the National Governors Association meeting said they wondered whether problems could be addressed using resources they already have.
“Are you suggesting the current system has more than sufficient funding?” Gov. Dave Heineman, R-Neb., said to the presenters. “We’re just not using it efficiently?”
Jeffrey Brenner, executive director of the Camden (N.J.) Coalition of Healthcare Providers, said the U.S. spends more money than any other country, but the states with the most efficient health care systems are those where the governors have “banged their fists on the table and said, ‘Let’s get this together.’ ”
Gov. Gary Herbert, R-Utah, said some problems aren’t easily fixed, such as the difficulty in trying to make change in a large, bureaucratic system.
“It gives us pause for thought for what we can do at the state level,” he said.
About 100,000 patients die every year because of provider errors, Brenner said, adding that they get great care at the hospital, but then are sent out into the world without follow-up care.
“There’s no incentive to do it,” he said.