State interest in healthcare cost containment has grown dramatically since Massachusetts enacted the nation’s first cost benchmarking program in 2012. At that time, most states were focused on coverage expansion through the Affordable Care Act. More recently, however, coverage gains have plateaued, and in some cases contracted, primarily because of affordability issues.

Seeking methods to better understand and control healthcare costs, many states are assessing how to build on Massachusetts’ benchmarking model. In 2019, the Oregon Legislature followed on the heels of Massachusetts when it enacted a benchmarking program to act as the state’s leading strategy for improving system transparency and accountability.