Making Coverage Affordable and Aligning Financing to Health Outcomes

Lowering the overall cost of care is important for Californians to be able to have access to affordable coverage.

Goal Highlights

Lowering the Cost of Care Indicators

Access to coverage means early detection and longer lives

As a result of the Affordable Care Act (ACA), the uninsured population in California has steadily decreased.

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Americans are paying more out-of-pocket for health care now than they did in the past decade.1

Health care can include more than just a monthly insurance premium. Most insurance plans require some form of out-of-pocket costs. People can choose a plan based on how much they want to pay out-of-pocket and when. Out-of-pocket costs include copayments, coinsurance, and deductibles.1

Tracking these costs is just one of the ways to monitor the overall cost of health care.

The currently available data visualization’s for this indicator presents average out-of-pocket health care cost per family and individuals per year, in U.S. dollars. This data represents one important piece in understanding out-of-pocket health care cost; in the future we also hope to present out-of-pocket cost as a percentage of household income.

Learn More » about Reducing Out-of-Pocket Cost for Healthcare

National health spending growth is expected to accelerate 5.7 percent for 20171

The overall cost of health care includes more than just out-of-pocket costs and insurance premiums. Tracking California's compound annual growth rate (CAGR) of health care spending is one way to monitor the overall cost of care. This indicator is valuable as it includes past trends in rate of spending on health care, and also helps predict what the rate of spending is going to look like in the near future.

The Let's Get Healthy California goal is to bring California's growth rate of health care expenditures in line with the rate of growth in Gross State Product (GSP) by 2022.

Learn More » about Reducing Rate of Spending on Healthcare Expenditures

Many Californians receive care in a fragmented system.1

Many Californians receive care in a fragmented system that does not emphasize coordination of care or take into account the higher costs of care received outside of the primary care setting. One form of an integrated health care system is managed care which refers to health care coverage that organizes doctors, hospitals and other providers into groups in order to enhance the quality and cost effectiveness of medical treatment.

Learn More » about Receiving Care in an Integrated System

The way we pay for health care does not reward providers for improving performance (CHCF Health Care payment in transition: A California Perspective)

How we pay for coverage and care in the US does not provide incentives that reward value (improved quality and services at a lower cost). Instead, our system provides incentives for higher volume, often leading to over-use of services and high costs.
There is an urgent need for payment reform in order to better align costs with health outcomes. (CHCF Health Care payment in transition: A California Perspective)
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