Seal of the State of Nevada



WHEREAS, Nevada's per capita health care spending has historically outpaced economic growth in Nevada;

WHEREAS, the rate of growth of health care costs impacts the ability of individuals and consumers to afford needed health care services and other necessary expenses; and

WHEREAS, enhanced transparency and shared accountability for a health care spending target can be used to accelerate changes in out health care delivery system, creating benefits for employers, state government, and Nevadans;

WHEREAS, the growth of health care expenditures affects the State's budget; and

WHEREAS, disparities in health care outcomes persist in Nevada among people of color, LGBTQ+ individuals, and other demographic factors; and

WHEREAS, Nevada must address the challenge posed by health care costs for all residents of Nevada, regardless of payer and provider; and

WHEREAS, the establishment, monitoring and implementation of an annual health care cost growth target is an appropriate means to establish accountability for bending the health care cost growth curve; and

NOW, THEREFORE, I, Steve Sisolak, by virtue of the authority vested in me as Governor by the Constitution and laws of the State of Nevada, do hereby order and direct the following:

Section 1:
The Nevada Health Care Cost Growth Target ("Target'') is hereby established for 2022 through 2026 as follows:
The Nevada Health Care Cost Growth Target ("Target'') is hereby established for 2022 through 2026 as follows:
 Year Median Wage
 Gross State
Product Weight
 Benchmark Value
2022 20% 80% 3.19%
2023 35% 65% 2.98%
2024 50% 50% 2.78%
2025 65% 35% 2.58%
2026 80% 20% 2.37%

Section 2:
The Target applies across all Nevada health care markets and populations.

Section 3:

The Agencies shall, within the scope of their legal authority:

a. Monitor health care spending growth across all public and private payers and populations in Nevada and report at least annually to the Governor on such growth;
b. Engage relevant parties, including insurers, providers, and community partners, to develop strategies to help meet the Target that are data-based and practicable;
c. Ensure that consumers and businesses purchasing health insurance share in the positive impact of the Target and related work.
d. Report annually during the fourth quarter on performance relative to the Target during the prior calendar year at:
  i. State, health insurance market (e.g., commercial, Medicaid, .Medicare, Medicare Advantage) and individual payer levels; and,
  ii. Accountable care organization (ACO) level for entities of a sufficient size, using clinical risk adjustment methodologies;
e.   No later than October 1, 2026 the PPC shall make a recommendation to the Governor regarding the appropriate cost growth benchmarks for the year 2027 and beyond.


Section 4:
The Division of Insurance, the Department of Health and Human Services, and any other relevant state agencies shall cooperate and coordinate with one another and with the PPC and its Executive Director to implement this Order.

Section 5:
Should the PPC find that there have been significant changes to the economy after the effective date of this Order, it may recommend to the Governor changes to the cost growth benchmarks set forth in Section 1, or recommend changes to the manner in which benchmark performance is assessed.

Section 6:
This Order is effective upon signature and shall remain in force, unless amended, modified, terminated, or rescinded by the Governor.

Footer State Seal

IN WITNESS WHEREOF, I have hereunto set my hand and caused the Great Seal of the State of Nevada to be affixed at the State Capitol in Carson City, this 27th day of December, in the year two thousand twenty-one.

Governor's signature