Annual Report on the Performance of the Massachusetts Health Care System: 2015

Publication Materials

The 2015 Annual Report on the Performance of the Massachusetts Health Care System includes a final calculation of the Commonwealth’s 2013 Total Health Care Expenditures (THCE) and an initial calculation of 2014 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 2015 Health Care Cost Trends Hearing, which took place October 5 and 6 2015.

Key Findings

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  • THCE was $54 billion in 2014, or $8,010 per capita, representing a 4.8% increase from 2013 and exceeding the health care cost growth benchmark by 1.2 percentage points.

  • Spending for MassHealth increased by $2.4 billion (+19%), while enrollment increased by 23%.

  • Total Medical Expenses per member per month among commercial payers grew by 2.9% in 2014, compared to a 1.2% increase in 2013.

  • The proportion of members whose care was paid using alternative payment methods in the commercial market rose slightly from 34% in 2013 to 38% in 2014.

  • In 2014, commercial cost of coverage increased by 2.6% (fully-insured premiums +1.6% and self-insured premium equivalents +3.4%), while benefit levels remained constant.

  • Member cost-sharing rose by 4.9% in 2014. Individual purchasers and small group members continued to pay the most out of pocket.

  • Increased enrollment in High Deductible Health Plans (now 19% of the commercial market) and tiered network plans (now 16%) may indicate growing employer interest in containing costs and, in some cases, shifting costs to employees.

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

Briefs on related topics will be published in the fall and early winter as part of the 2015 Performance of the Massachusetts Health Care System Briefing Series.

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