CHIA Poster Presentations for the 2016 AcademyHealth Conference

The Annual Research Meeting, hosted by AcademyHealth, brings together a wide variety of stakeholders leading the charge to transform delivery systems and health care in a rapidly changing landscape.

The Center for Health Information and Analysis (CHIA) participated in the 2016 Annual Research Meeting in Boston, presenting on topics ranging from unplanned hospital readmissions to lessons learned through the development of metric designed to track statewide health care spending in Massachusetts.

Early Observations from Massachusetts’ Efforts to Curb Health Care Spending Growth

by Po-Yu (Alex) Lai, Sc.D., Caitlin Sullivan, MPH, Ellyn Boukus, MA
Total Health Care Expenses (THCE) Example 

The Commonwealth of Massachusetts recently implemented a  first-in-the-nation approach to measuring and benchmarking  growth in statewide spending on health care.  

Under a key provision of the 2012 Massachusetts health care cost containment law, the Center for Health Information and Analysis  (CHIA) is charged with calculating Total Health Care Expenditures  (THCE) and comparing its annual growth against an established  health care cost growth benchmark.

The purpose of this presentation is to share lessons learned in the development and implementation of this initiative and to inform  new and existing efforts focused on health care cost containment at the state level. 

See additional information on Total Health Care Expenditures.

Characteristics of All-Payer Patients with Frequent Hospitalizations in MA Acute Care Hospitals

by Zi Zhang, Nick Huntington, Amy Boutwell
Frequent Hospital Readmissions Poster 

Unplanned hospital readmissions are costly and have significant impacts on patient health and experience of care. Studies of Medicare Fee-for-Service beneficiaries have suggested that high proportions of unplanned readmissions could be contributed by a small group of patients.

The objectives of this study are to:

    • Assess the prevalence of frequently hospitalized patients among the all-payer population being served in Massachusetts acute care hospitals.

    • Assess the impact of frequent hospital users on hospital wide all-payer readmissions.

  • Describe the characteristics of frequently hospitalized patients.

Behavioral Health and Readmissions among Patients in Massachusetts Acute Care Hospitals

by Zi Zhang, Nick Huntington, Amy Boutwell, Sarah Newsky, Nick Huntington, and Huong Trieu
poster bh readmission

There is a growing recognition in the healthcare community that patients with comorbid behavioral health conditions may be at higher than average risk of readmissions.

    • Efforts to reduce readmissions should include identifying readmission risk factors associated with this group.

  • Little information available on the prevalence of behavioral health comorbidities among hospitalized and readmitted patients on an all-payer, all-condition basis.

Research Questions

    • What is the prevalence of behavioral health comorbidities among hospitalized patients in Massachusetts acute care hospitals? How do these prevalence rates vary by patient demographic and payer type?

  • What are the readmission rates for patients with and without behavioral health comorbidities?

Renin Angiotensin System Antagonist Medication Adherence in the Massachusetts All Payer Claims Database by Primary Refill Method Among Individuals with Documented Hypertension in 2012  

by Amy Bettano,  Sylvia Hobbs, Betty Harney, Laura Nasuti
Hospital Readmissions Example 
The research objective was to examine the rate of adherence to Renin Angiotensin System Antagonist (RASAs) medications among patients with documented hypertension in the Massachusetts’ All Payer Claims Database (MA APCD) and to understand factors that affect adherence; rates of refill adherence were compared between patients using mail-order prescription refills versus pharmacy prescription refills.


The MA APCD is a comprehensive database which covers the majority of residents in the state and offers a unique perspective on health care utilization. RASA prescription insurance claims filled in 2012 for three commercial insurance companies were extracted from the MA APCD.

Time for Changes in the Reporting of Diagnosis Codes in Administrative Data  

by Sylvia D. Hobbs, Anne Medinus, Adam Tapply
Hospital Readmissions Example 

The completeness of diagnosis (dx) codes is a key data quality metric influencing the usability of health care data for comorbid analysis and severity adjustment. AHRQ revealed sizeable state by state variation in the number of ICD-9-CM codes collected in administrative hospital discharge data (HDD), ranging from less than 10 to greater than 60 dx codes.

Until 2015, Massachusetts (MA) HDD had a limit of 15 dx codes on its submissions. As the US sunsets ICD-9-CM (which contains approximately 14K dx code definitions) and transitions to ICD-10-cm (68K codes), we sought to measure the magnitude to which MA HDD discharge records reached the maximum 15 dx code limit by gender, disposition, major dx categories and payer-type over a15-year period spanning before and after MA Health Care Reform (HCR).