It is a well-known fact that per-capita health care costs are higher in the United States than other countries. In 2010, the U.S. spent 18 percent of its gross domestic product on health care expenses, while many other countries spent less; for example, France and Germany spent 12 percent, Canada spent 11 percent, Greece and the United Kingdom spent 10 percent, and Italy spent 9 percent (OECD Health Data Set 2012).

Many issues impact health care and multiple rationales for the higher health care costs in the U.S. have been argued; likewise, numerous approaches including governmental and private market approaches have been suggested for containing health care costs. Some general governmental approaches include: structuring the health care market, providing oversight of financing and health care service provision, ensuring transparency in and analysis of the health care sector, and convening and building consensus among market participants. Three general types of private market approaches include changes in health plan designs, provider reimbursement strategies, and provider networks.

Policy options approved by JCHC members included such second-year study activities as:

• Creation of a workgroup comprised of representatives from JCHC, the Virginia Chamber of Commerce, and State government, to review promising cost-containment and efficiency strategies that also consider and maintain health care quality. Meetings will be open to the public and include presentations and input from health-care sector representatives.

• Presentations by the Virginia Chamber of Commerce on Blueprint Virginia’s Healthcare Industry Council and by the State Health Care Cost Containment Commission (a broad-based commission funded by Kaiser Permanente and the Robert Wood Johnson Foundation and organized by the University of Virginia Miller Center).

• Collaboration involving representatives of State agencies, stakeholder groups, and the Virginia Center for Health Innovation to identify statewide core regional population health measurements for potential collection and dissemination and to identify 25 quality and safety measures that if targeted could most improve hospital-related care, including readmissions.

Furthermore, during the second year of the study, such issues as the likely impact of Patient Protection and Affordable Care Act provisions on the cost of health care; health care expenditures in the U.S. will be compared with such expenditures in other countries; and the regional concentrations of providers, hospitals and insurers will be examined.

The final written report will be submitted for publication in 2015.