Gov. Cox announces plan for real-world experiments aimed at making Utah health care more affordable

The experiments will help determine how certain changes could translate into big savings.

(Kristin Murphy | pool photo) Gov. Spencer Cox speaks with media during the PBS Utah governor's monthly news conference at the Eccles Broadcast Center in Salt Lake City on Thursday, Nov. 18, 2021.

State officials are planning to bring together health care providers and others to develop ways to make health care more affordable, Gov. Spencer Cox announced Thursday.

The new “collaborative” could devise test runs for an array of changes to how various health care services are provided and how they are paid for, Cox said.

“You’re thinking, ‘We’ve done this before, we’ve tried this in the ’90s, we tried it in the early aughts,” Cox said. “Maybe we’re just destined to have increasing health care costs and worse outcomes.”

But a lot of cost-containment efforts attempted previously have fizzled out even if they were successful, because they didn’t become widespread enough for insurers to buy into them and provide coverage, said Mary Jane Pennington, CEO of Granger Medical Clinic, which operates clinics along the Wasatch Front.

For example, the clinics tried hiring extra staff to stay in touch with patients who were transitioning from hospital care to at-home care — to help them keep their drugs organized, make sure they have enough supplies and avoid infections or other problems. Immediately, those patients showed a 15-20% decrease in readmissions to hospitals, Pennington said — a big savings that other providers could replicate.

But insurers don’t always cover extra services, even if they save money in the long run. For instance, the Granger clinics obtained grant funding to pair family doctors with pharmacists at the University of Utah, to keep an eye on medication interactions and identify cheaper alternatives to expensive drugs.

But, she said, grants run out, and “almost none of our [insurers] pay for this service for patients.” The state’s new collaborative could help fund those services “until we can prove they have a good return and insurance companies are prepared to cover them,” Pennington suggested.

Cox said the collaborative could, for example, test out plans to merge physical and behavioral health care, or streamline health care services for rural patients.

But the collaborative is far from taking shape, or action. Cox’s office plans to form an advisory board by the end of January, then form a governance team in May or June.

“We don’t know a lot of the other particulars about this,” said Rich Saunders, Cox’s chief innovation officer.

Saunders invited the public to nominate members of the governance team at healthcollaborative.utah.gov.