We first kicked off Going Below the Surface in February 2018 by comparing the health policy landscape to “Groundhog Day,” the Bill Murray cult classic movie in which his character faces the same events, day after day, until he finally experiences a breakthrough, changes his life and moves forward.

A year later – like Murray’s iconic weatherman character – we’re still waking up to the same sounds – but the tune is beginning to change. Amidst the noise of congressional hearings, proposed regulations and outcries over out-of-pocket costs, we’re also hearing constructive conversations about how to address health spending without pointing fingers or slashing and burning our way to lower spending.

A guiding principle of Going Below the Surface has been to dig deeper and examine the true drivers behind health care spending to ensure that public and policymakers alike understand the root causes of high prices, the stakes and the tradeoffs involved.  And by that count, 2018 was an excellent year: The Going Below the Surface initiative— and a complementary effort with Anthem and Health Affairs, Considering Health Spending – has highlighted more than 50 pieces of critical research and articles and connected experts to better understand the underlying causes of health spending year and propose solutions that put patients back at the center of health care.

Asking the Hard Questions

With Going Below the Surface, we knew asking the tough questions about health spending was central for breaking the cycle in today’s dialogue around health spending.  Among those immediate questions, we sought to understand what we can learn from health care spending in other countries, and whether or not those learnings could be applied in the U.S., given our different health care systems. We also considered how to better allocate resources from low-value care to high-value care; how to incentivize and equip consumers with information about their health benefit choices, and the tradeoffs needed to control health care costs; and under which circumstances health spending can be cost-effective and improve health outcomes. The answers to these questions, published in peer-reviewed research, provide us with some direction on next steps, but we have more challenges to address. We’re heartened by the increase in research on these important topics, as well as by the “Considering Health Spending” series in Health Affairs and the interest it has generated in this dialogue.

Collaborating Across the Health Care Ecosystem

Given the interconnectedness of our health care system, bringing a variety of stakeholders together as part of the spending dialogue was an important priority. Today, 20 member organizations have met as part of the Going Below the Surface forum to set priorities and identify actionable next steps to address them. Low-value care is the first area of agreement among our members, and over the past year we’ve leveraged Going Below the Surface as a central platform to highlight research, perspectives and context to identify and minimize sources of low-value care moving forward.

Many critical aspects of health care spending, including low-value care, remain unaddressed by stakeholders, but we will continue to elevate these evidence-based conversations around health spending as it only continues to gain traction in 2019. As always, we thank you for your continued support of Going Below the Surface and encourage you to join the #GoingBelowTheSurface conversation.