October 8, 2021

Input Needed on Health Care Cost Transparency Board Benchmarks

In 2020, House Bill 2457 established a health care cost transparency board tasked with annually calculating total health care expenditures and health care cost growth, and establishing benchmarks for health care spending. Meeting monthly since February, the board has recently established these benchmarks-and an aggressive timeline for meeting them. Due to the troubling trajectory of this work, we need to hear from members on how these decisions may impact patient care at your practice.

Quick summary of the issue

To meet its goals of transparency and a reduction in the growth of costs, the health care cost transparency board will publicly identify health systems, physician practices, providers, and payers that exceed established total cost of health care benchmarks. Those benchmarks, as established by the board at its September 2021 meeting are:

• 2022-2023: 3.2%
• 2024-2025: 3.0%
• 2026: 2.8%

The board is required to review and consult with entities that exceed the benchmark before publicly identifying them. While there is no enforcement mechanism or penalty for those that exceed the benchmark, the WSMA expects the Legislature to give the board more "teeth" in future years.

How you can help

The WSMA is participating in an advisory capacity to the board. Due to our concerns around this work to date, we need to hear from you now to make sure the state understands the perspective of all practice types and specialties that are potentially subject to the benchmark. Real world examples are very helpful-for example, what actions would you need to take at your practice to come in under the 3.2% growth benchmark in 2022? What steps would you need to take to ensure your costs do not exceed 2.8% in 2026? Send us your feedback at policy@wsma.org.

For background on the board, details on its work, and details on WSMA's concerns around the benchmarks and accompanying timeline, visit our new Health Care Cost Transparency webpage on the WSMA website under Advocacy.