Healthcare Affordability: Untangling Cost Drivers

“You can’t fix what you don’t understand, but with reliable information on cost drivers we can begin to make the changes needed to make healthcare more affordable.”
Elizabeth Mitchell
Former President and CEO, NRHI

This interactive page features resources that can enable stakeholders to take action, both locally and nationally, to address healthcare affordability. Click on an icon below to get started.

What is the HealthPartners Measure?

This Getting to Affordability learning module details HealthPartners’ Total Cost of Care Framework, how it is calculated, and how it can be used.

View (goes to What is TCOC learning module) 

This white paper, created by HealthPartners, provides an in-depth look at TCOC. 


Stakeholder Resources


Providers developing referral patterns that guide patients to high-value care

“We’re getting a lot more interest from providers, who want to see how they compare to peers and what’s driving the cost of care in their practice. Many also are interested in knowing how care delivery and pricing in Utah compares to other states. there’s power in the local results and in the benchmark report and they are even more powerful when we pair them together.“- Rita Hanover, Senior Healthcare Analyst, HealthInsight Utah

Oregon Health Care Quality Corporation’s sample report includes claims incurred from January 2014 to December 2014. The goal of the Clinic Comparison Report is to demonstrate clinic variation in cost and quality compared to a state average.


Learn lessons from the field from the University of Texas on engaging physicians in transparency. 


Physician leaders have added challenges in that they must help the provider see beyond their natural tendencies to be autonomous, errorless and a strong sense of being isolated from the rest of society by nature of their profession. It all starts with establishing a mutually supportive and respectful relationship. This report shares key takeaways from NRHI’s National Physician Leadership Seminar in August of 2016.


Policy Makers

State policymakers budgeting limited government resources

“There is tremendous interest in this benchmark report in Oregon. Legislatures see it as an important source of information as they consider how to create a higher-value healthcare system for our state.”– Meredith Roberts Tomasi, Senior Director, Oregon Health Care Quality Corporation

Read the published report from the National Affordability Summit in this informative and honest depiction of the state of our healthcare system and the work we need to do to make care affordable for Americans.


In 1960, $1 in $20 was spent on healthcare. Today that number is $1 in $6. What can we do to change this? 

Elizabeth Mitchell, former NRHI president & CEO, shares her thoughts on the Health Affairs blog. “For months, the US public has watched Congress debate the future of the US health care system—or more accurately—the future of the Affordable Care Act. But despite all we heard about deductibles and bronze versus silver plans, the debate in Washington was focused on the wrong thing. We can’t have affordable insurance until we have affordable health care, and we won’t have affordable health care until we address the drivers of rising health care costs…”

Read more by visiting the blog today.


Employers and health plans aligning benefit design and provider payments with higher quality, lower cost of care

“The benchmark data provides national health plans, employers, and medical associations with comparative cost information across states and insights regarding which service categories may be driving observed differences. At CIVHC, we’ve recently begun a formal collaboration with the Colorado Business Group on Health because both organizations know how valuable this data is to the employer community in supporting better informed healthcare purchasing decisions. “– Jonathan Mathieu, Vice President for Research and Compliance and Chief Economist, CIVHC

Following the National Employer Leadership Seminar guidance for employers was distributed to attendees. Purchaser Roadmap: Pathway to Better Value provides purchasers an overview of opportunities and best practices associated with the implementation of various value-based purchasing strategies shared at the two-day seminar.


 In this learning module you will hear from purchasers about national efforts to address affordability, how regions can work collaboratively with purchasers to influence and drive the availability of affordable healthcare, and tips from employers who are doing this work.

View ( LEarning module with the same title

Health Plans

Employers and health plans aligning benefit design and provider payments with higher quality, lower cost of care

“We share comparative cost, resource use, and price information with our local health plans as well as our providers. We include information on the benchmark as well so they can see how our state compares to others.” – Gunnar Nelson, Health Economist, MNCM

Hear from the Washington Health Alliance on how they secured the commitment from the six major commercial insurers, the five Medicaid Care Organizations and the largest self-insured purchasers in Washington State to support their voluntary APCD. 


Hear from The Health Collaborative on how they achieved full stakeholder buy-in to move forward with public reporting on cost data. 



Consumers choosing healthcare providers with an eye toward their own healthcare spending 

“We’re going to include the regional benchmark information on our website. The benchmark shows Maryland as a market with relative value. It’s a nice complement to, which shows the local variation in cost of care for certain procedures.” – Linda Bartnyska, Director, Center for Analysis and Information Services, MHCC

The Maryland Health Care Commission is providing this cost and quality information so that patients and providers are aware of how cost and quality differs among hospitals. With this information everyone in Maryland can join a statewide conversation to better understand the differences in cost and quality that exist, work together to find solutions to reduce those differences, and help patients make the best choices for their care.

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Too often, patients may receive care that not only does not improve their health, but may increase their risk and cost. In an effort to ensure that patients get the care they need, over 50 specialty societies have joined the Choosing Wisely® campaign. See how Choosing Wisely is helping people and their physicians communicate and make shared decisions about the type of care that is right for them.

Learn more