Utah leaders discuss health care cost drivers and how to increase affordability

By Regence
March 11, 2024
State of Reform UT 2024 panel banner

Main image (L-R): Panelists Rep. Norm Thurston, state representative at Utah House of Representatives; Sharon Lamberton, MS, RN, deputy vice president for state policy and external outreach at PhRMA; Sri Bose, PhD, MA, director of research at One Utah Health Collaborative; Eric Hales, MHA, CHIE, vice president of network management at Regence BlueCross BlueShield of Utah; and Moderator Spencer Morrison, associate principal at Leavitt Partners.

Multiple factors are driving escalating health care costs and intensifying affordability issues nationwide. During a panel discussion at the recent Utah State of Reform Health Policy Conference, experts shared what is being done and future solutions to address this challenge in Utah.

Eric Hales, vice president of network management for Regence BlueCross BlueShield, set the stage by sharing statistics that illustrate why growing health care costs are not sustainable:

The 2023 annual Milliman Medical Index estimated the following costs for a family of four in Salt Lake City alone:

  • Employee contributions and out-of-pocket cost: about $19,000
  • Pharmacy costs: More than $6,000
  • Total annual cost of health care: nearly $46,000

Panelists shared their thoughts on factors contributing to increasing costs in Utah. There was consensus that higher prices for patient services and medications are key drivers.

“We’re working to better understand where spending occurs and identify trends,” said Sri Bose, PhD, MA, director of research at One Utah Health Collaborative. “In collaboration with payers, providers and pharmaceutical firms, we’re gathering data on utilization and drug pricing. Then we’ll analyze it to determine trends, set cost reduction goals, and inform future decisions.”

This discussion transitioned to potential solutions for disrupting consistently rising costs and increasing affordability for Utahns.

“Health care prices have unnecessary components baked in and it’s a challenge to remove them,” said state Rep. Norm Thurston (R-Provo). “We need to determine what things should cost compared to what they cost now.”

Sharon Lamberton, MS, RN, deputy vice president of state policy and external outreach at PhRMA pointed out, “solutions to address drug prices must be based on data.” She also noted that access to care is important too. “We can’t focus only on price.”

Regence is working to share pharmaceutical and provider utilization data with One Utah Health Collaborative to help determine true cost drivers. This nonprofit organization was launched in 2022 to transform health care in Utah through collaboration and innovation.

“We’re also leveraging opportunities to drive down costs,” said Hales. “We reward providers for keeping costs low and share savings with them while rewarding hospitals systems for high quality care. We’re making sure members have options like access to more affordable sites of care and lower cost biosimilar and generic medications.”