The Massachusetts Health Care Cost Growth Benchmark and Accountability Mechanisms: Implications for State Policymakers

To contain health care cost increases, Massachusetts enacted Chapter 224 in 2012, which established a first‐in‐the‐nation target, called a benchmark, for annual growth in total statewide health care spending. Among other things, the law created a Health Policy Commission and granted it authority to hold payers and providers accountable for keeping annual cost growth below the benchmark. To better understand the influence of the initiative and the accountability mechanisms used, the study team conducted a comprehensive review of public documents and drew insights from nearly 50 interviews with key people who were involved in, or affected by, the Massachusetts cost growth benchmark. This issue brief summarizes key study findings and raises lessons and considerations for state policymakers about the design and use of accountability mechanisms to meet a health care cost growth benchmark.