Annual Report on the Performance of the Massachusetts Health Care System: 2016

Publication
Materials

• 2016 Annual Report
• Technical Appendices (zip file;124 KB)
• Databooks (zip file; 1.1. MB)

Key Findings

• 2015 initial THCE was $57.2 billion, or $8,424 per capita, representing a 3.9% increase from 2014 and exceeding the health care cost growth benchmark by 0.3 percentage points.
  
  

• PMPM spending for commercial full-claim members grew 1.7%; and declined 3.1% for MassHealth Direct, as enrollment outpaced medical spending. Traditional Medicare spending rose faster than enrollment, resulting in PBPY growth of 2.0%.
  
  

• After several years of increases, the proportion of commercial members whose care was paid for using alternative payment methods declined by 1.9 percentage points in 2015 to 35.1%.
  
  

• Pharmacy spending continues to grow at a substantial rate (10.1% in 2015, following 13.5% in 2014). This spending growth accounts for one-third of the  overall growth in THCE.
  
  

• Individual enrollment more than doubled to 170,000 enrollees as subsidized and unsubsidized coverage became available through the Health Connector.
  
  

• One in five Massachusetts commercial members (21%) were enrolled in a high deductible health plan. Membership increased by 14% to nearly one million members.
  
  

• Cost-sharing among private commercial members continued to increase faster inflation and wage growth. Members continue to bear a greater share of health care costs.
  
  

• The quality of Massachusetts providers was generally at or above national benchmarks, but there was performance variation across providers.