Jan, 12, 2017

New Brief Features Opportunities to Address Population Health Goals through Jointly Employed Measurement and Accountability Tools

As states gear up to consider their new budgets, we should expect palpable anxiety about health care spending. States have spent more and more on health care over the years and will be called to do so again. That increased spending hasn’t automatically translated into better health and well-being, though. In fact, many policymakers express concerns that medical inflation crowds out investments in other areas like education, housing, and transportation that tend to prevent issues from escalating into health problems.

State leaders have traditionally responded to the challenge by expanding the pie (e.g. looking to Washington, D.C. for Medicaid funding and health insurance tax credits) or seeking value within the health care system (e.g. payment reform and coordinated care). Real progress – progress that breaks this unsustainable cycle – will leverage cross-sector partnerships that support population health efforts aimed at preventing people from becoming sick or needing expensive care. Health care leaders and their peers across government are well-positioned to guide the development and implementation of these approaches to drive improvements in population health.

In the brief we released today, we outline (1) best practices for state policymakers and health care leaders as they approach this old challenge from a new perspective, (2) one state’s experience in making them happen, and (3) a tool-kit for policymakers to jumpstart the process in their own state.

We began with jointly-employed measurement and accountability tools. Although technical, they’re what it will take for policymakers to break the cycle and allow taxpayers’ dollars to go further. The hard work, patience, and persistence it takes to forge and execute these partnerships will pay off by improving health outcomes not possible through isolated, medical-centric efforts alone.

Progress has already been made along these lines within the health care system.  More and more, payers are measuring performance, incentivizing key results, and making them publicly available. We need to broaden the scope of these efforts and closely align them with other policy goals.

Doing that successfully requires five pre-requisites:

  1. Shared understanding
  2. Goal alignment
  3. Leadership support
  4. External stakeholder engagement
  5. A clear decision-making process among policymakers

Oregon has experience forming these sorts of cross-sector partnerships and has been using jointly-employed measurement and accountability tools to improve health outcomes and educational achievement, since 2011. Other states can learn from its experience and tailor their approach to the particular needs of their citizens and structure of their state government.

There is great opportunity – regardless of a state’s size, geography, demographics, or politics. Health care spending takes up a significant (and ever increasing) portion of state budgets, and there is often a poor return on spending increases made over the years. With these cross-sector partnerships, states can redirect some of their health care dollars into investments that will pay off in healthier, more productive people that live longer and happier lives with their friends, family, and community.