Annual Report on the Performance of the Massachusetts Health Care System: 2017

Publication Materials

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The 2017 Annual Report on the Performance of the Massachusetts Health Care System includes a final calculation of the Commonwealth’s 2015 Total Health Care Expenditures (THCE) and an initial calculation of 2016 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 will inform the Health Policy Commission’s 2017 Health Care Cost Trends Hearing, which will occur on October 2 and October 3, 2017.

Key Findings

    • THCE totaled $59.0 billion in 2016, or $8,663 per capita. This represents an increase of 2.8% from 2015, below the health care cost growth benchmark.

    • Overall spending increased across all major insurance categories, but at more moderate rates than in prior years, and declined for the net cost of private health insurance.

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

    • Adoption of APMs grew by 6.3 percentage points in the commercial market in 2016, driven by a 13.5 percentage point increase among PPO members.

    • TME increased in 2016 for commercial and MassHealth MCO members, and decreased for Medicare Advantage members.

    • Private commercial insurance enrollment of individual purchasers grew 34.5% between 2015 and 2016, while enrollment in ESI decreased slightly (-0.6%).

    • Premiums for individual purchasers declined by 3.4% from 2015 to 2016, while ESI premiums rose 3.9%.

  • Between 2015 and 2016, member cost-sharing continued to grow at a faster rate (4.4%) than average income and premiums.

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