A nonpartisan health policy brain trust is shifting gears in 2020 to help state lawmakers tackle hospital costs, and the switch is funded by a Texas billionaire couple who have become major players in the national healthcare policy debate.

The National Academy for State Health Policy late last year created a new center to help states address healthcare system costs. The center plans within the next month to release between eight and 12 pieces of model legislation to help states lower healthcare spending, academy Executive Director Trish Riley said.

The group had previously been focused on developing policy solutions to lower prescription drug prices and providing technical support for drug importation proposals, but Riley said she has seen an appetite from states to address spending including hospital costs.

"We have always been deeply concerned about healthcare costs," Riley said. "Pharmacy was a toe in the water, and is a smaller part of the overall cost picture."

The new center is being funded by the Laura and John Arnold Foundation, a not-for-profit that has been deeply entangled in funding drug-pricing policy change on several fronts. The group has funded the hospital-led not-for-profit generic-drug manufacturer Civica Rx; a patient advocacy group based in D.C.; the controversial drug-value research group the Institute for Clinical and Economic Review; and other initiatives.

A spokesman for the Arnold Foundation's parent entity said the not-for-profit is expected to give the academy $2.2 million in grant funds in 2020 for several projects, a nearly $200,000 increase from 2019 funding levels.

The policy development will be guided by a group of 17 state health policy officials, lawmakers, and attorney general staff from states including California, Connecticut, Colorado, Delaware, Georgia, Maine, Maryland, Massachusetts, New Mexico, North Carolina, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, Washington and Wisconsin.

There is no industry representation in the working group, but Riley said the group is aware that healthcare system landscapes vary greatly state-by-state and is conscious of protecting access to care through rural hospitals.

"All states have different situations, and different issues will lead to different policy solutions," Riley said.

The new initiative is led in part by Deborah Fournier, a former New Hampshire Medicaid director who most recently worked at the Association of State and Territorial Health Officials, where she addressed rural hospital sustainability and alternative payment structures.

Anya Rader Wallack, a professor at Brown University who has held leadership positions in state government agencies and insurers, and Nancy Kane, who served on the Medicare Payment Advisory Commission and the Massachusetts Special Commission on Health Care Cost Containment, will serve as consultants on the template legislation.

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