Annual Report on the Performance of the Massachusetts Health Care System: 2018

Annual Report

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Individual Purchasers
In The
Massachusetts Health Care System

This brief, published in June 2018, explores trends in unsubsidized and ConnectorCare plans that were touched upon in CHIA's 2017 Annual Report.

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The 2018 Annual Report on the Performance of the Massachusetts Health Care System includes a final calculation of the Commonwealth’s 2016 Total Health Care Expenditures (THCE) and an initial calculation of 2017 THCE. THCE is a measure of total statewide health care spending in the Commonwealth.

The report also includes information from public and private sources related to specific health care expenditures for Massachusetts residents, quality of care in the Commonwealth compared to national performance, enrollment and coverage trends, premiums and member cost-sharing, and payer use of funds.

This report informed the Health Policy Commission’s 2018 Health Care Cost Trends Hearing, which was held on October 16 and 17, 2018.

Key Findings

    • THCE totaled $61.1 billion in 2017, or $8,908 per capita; this represents an increase of 1.6% from 2016, below the health care cost growth benchmark.

    • Total MassHealth spending decreased by 0.2% in 2017, driven in part by a 2.4% decrease in enrollment.

    • Annual growth in fully-insured premiums accelerated—from 2.0% in 2016 to 4.9% in 2017.

    • Between 2016 and 2017, member cost-sharing continued to grow at a faster rate (5.7%) than inflation, average wages, and premiums.

    • By 2017, 28.2% of members with private commercial insurance were enrolled in high deductible health plans.

    • Pharmacy and hospital outpatient spending remained the largest drivers of THCE growth.

    • TME increased in 2017 for commercial and MassHealth MCO members, and decreased for Medicare Advantage members

  • Adoption of APMs decreased by 1.3 percentage points in the commercial market in 2017, driven largely by a decline in HMO members covered under an APM.

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