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Abstract

State lawmakers nationwide are looking for solutions to the high healthcare prices faced by patients and employers. One of the emerging policies to combat rising costs is a shared savings program. These programs allow patients to compare prices and receive incentives for saving money on elective services. Maine and New Hampshire both passed legislation to enact shared savings programs implemented between 2019 and 2022. New Hampshire’s program established for a large, self-insured employer outperformed programs in both states in the fully insured competitive market, saving patients 183 times more than participants in Maine’s program during that timespan. Stakeholders and policy experts interviewed for this project highlighted several themes to explain the disparity in program outcomes. They identified aligning incentives across patients, employers, providers, and insurers as the most crucial program design element for policymakers to consider when implementing similar programs in the future.

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