August 29, 2013

States experimenting to lower health care costs

The Associated Press

(Continued from page 2)

Health spending per capita

     Avg. annual growth   1991-2009

 Percent growth

United States

$6,815

6.50%

Alabama

$6,272

5.90%

Alaska

$9,128

8.40%

Arizona

$5,434

7.80%

Arkansas

$6,167

6.60%

California

$6,238

5.90%

Colorado

$5,994

7.30%

Connecticut

$8,654

5.80%

Delaware

$8,480

7.70%

District of Columbia

$10,349

4.50%

Florida

$7,156

6.90%

Georgia

$5,467

6.60%

Hawaii

$6,856

6.20%

Idaho

$5,658

7.90%

Illinois

$6,756

5.80%

Indiana

$6,666

6.30%

Iowa

$6,921

6.10%

Kansas

$6,782

6.20%

Kentucky

$6,596

6.70%

Louisiana

$6,795

5.70%

Maine

$8,521

7.40%

Maryland

$7,492

6.60%

Massachusetts

$9,278

6.40%

Michigan

$6,618

5.60%

Minnesota

$7,409

7.00%

Mississippi

$6,571

7.00%

Missouri

$6,967

6.70%

Montana

$6,640

7.00%

Nebraska

$7,048

6.90%

Nevada

$5,735

9.20%

New Hampshire

$7,839

7.60%

New Jersey

$7,583

6.00%

New Mexico

$6,651

7.70%

New York

$8,341

5.90%

North Carolina

$6,444

7.90%

North Dakota

$7,749

6.20%

Ohio

$7,076

5.80%

Oklahoma

$6,532

6.70%

Oregon

$6,580

7.50%

Pennsylvania

$7,730

5.70%

Rhode Island

$8,309

6.30%

South Carolina

$6,323

7.30%

South Dakota

$7,056

6.90%

Tennessee

$6,411

6.60%

Texas

$5,924

7.30%

Utah

$5,031

7.90%

Vermont

$7,635

7.30%

Virginia

$6,286

6.90%

Washington

$6,782

7.30%

West Virginia

$7,667

6.30%

Wisconsin

$7,233

6.70%

Wyoming

$7,040

7.60%

The Massachusetts regulations provide money to accelerate electronic record-keeping and create tax credits for businesses that adopt wellness programs to combat preventable chronic diseases.

Cost-containment efforts are not confined to states that have embraced Obama's health care reforms.

Many Southern states are transitioning their Medicaid patients into managed-care programs, which receive a fixed amount of money for each patient, regardless of their costs. Some insurance companies are thinning their networks of doctors to funnel patients to lower-cost options.

South Carolina, for example, is targeting elective early births, trying to keep newborn babies out of the expensive neonatal intensive care unit. The state also trained 18 community health workers who are in clinics that see a large number of Medicaid patients.

There are substantial challenges to copying these experiments nationally. Adopting a technology system to keep medical records electronically, for example, entails substantial upfront costs, as does hiring staff to coordinate patient care. At the same time, providers have to be careful to avoid skimping on needed care to save money.

Most of the experiments are too new to produce reliable data about their success, but health policy experts warn that the rapid rise in costs is unsustainable.

"It has to end eventually," said Larry Levitt, senior vice president of the Kaiser Family Foundation, "because we can't have an economy driven entirely by health care."

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