Identify Opportunities
We conduct thorough research and analysis to pinpoint areas for individual and collective action.
SPENDING GROWTH MEASUREMENT
Timeline
December 2024-June 2025
Objective
Collect healthcare spending data from payers at the aggregate level for the past three years (2021-2023) on claims by category, non-claims by category, pharmacy rebates, market enrollment, administrative cost, and primary care provider attribution
Results
A report on total healthcare spending trends at the state and market level—commercial (including self-insured), Medicaid, and Medicare—from 2021-2023, covering total medical spending trends by claims and non-claims categories, which include inpatient, outpatient, professional, pharmacy, primary care, behavioral health, long-term care, specialty providers, performance incentives, prospective payments, and primary care provider attribution
In Spring 2024, the Collaborative announced the formation of a Technical Advisory Group (TAG) that will collaborate and provide data to estimate Utah’s total healthcare spending baseline and trends. The TAG members and respective organizations represent more than 95% of insured Utahns.
Participating insurers include:
- Aetna/CVS Health
- Cigna
- Health Choice Utah
- Molina Healthcare of Utah
- Public Employment Health Plan (PEHP)
- Regence BlueCross BlueShield of Utah
- Select Health
- UnitedHealthcare (UHC)
- Utah Medicaid
- University of Utah Health Plans
COST-DRIVER ANALYSIS
The Collaborative is analyzing healthcare spending levels and identifying cost drivers to inform policy decisions and uncover opportunities to make healthcare costs for Utahns more affordable.
Timeline
December 2024-June 2025
Objective
Use All Payers Claims Database (including Medicaid), Medicare database and HealthCare Facility Database from 2019-2023
Results
A report tracking spending growth (e.g., spending, price, utilization) by major service category (e.g., inpatient, outpatient, long-term care, professional, medical and retail pharmacy, behavioral), chronic conditions, and by market, year, geography, and socio-demographic factors (e.g. age, gender)
CURRENT PRIORITY AREAS
Pharmaceuticals
Reinsurance
