CHIA Standard Statistics


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Health Care Comparative Statistics: Massachusetts and the United States

CHIA identifies, calculates, disseminates, and maintains a specific set of standard statistics that measure the performance of the Massachusetts health care system. The information in the table below is derived from CHIA's unique data sets or other Massachusetts-specific reliable sources.

CHIA's two main areas under its standard statistics:

 


Spending and Insurance Coverage

MeasureMost Recent DataPrevious DataData
book
Additional
Data
Fact
Sheet

Total Health Care Expenditures
(Learn More)

$8,441 per capita
+ 4.1% from CY 2014 to CY2015
$8,109 per capita
+4.2% from CY2013 to CY2014
Link to data

Link to fact sheet

Total Medical Expenses for Commercially-Insured Members
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$442 PMPM in 2015
+2.7% from CY 2014 to CY2015
$430 PMPM in 2014
+3.7% from CY2013 to CY2014
Link to data

Link to fact sheet
Insurance Rate of Massachusetts Residents
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96.4% in 2015

96.3% in 2014
Link to data
Link to fact sheet

Percent of Massachusetts Employers Offering Health Insurance

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76% in 2014
76% in 2011
Link to data
Link to fact sheet

Average Cost of Commercial Coverage

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Fully- and Self-Insured
$440 PMPM in CY2015
+1.9% from CY2014 to CY2015
$431 PMPM in CY2014
+3.3% from CY2013 to CY2014
Link to data
Link to fact sheet
Fully-Insured Premiums
$443 PMPM in 2015
+ 1.6% from CY2014 and CY2015
$436 PMPM in 2014
+1.4% from CY2013 to CY2014
Self-Insured Premium Equivalents
$437 PMPM in 2015
+ 2.1% between CY2014 and CY2015
$428 PMPM in 2014
+5.0% from CY2013 to CY2014

Commercial Health Insurance Benefit Levels (Actuarial Values)

(Learn More)

Fully- and Self-Insured
0.898 in 2015
0.902 in 2014
Link to data
Link to fact sheet
Fully-Insured
0.876 in 2015
0.878 in 2014
Self-Insured
0.914 in 2015
0.920 in 2014

Average Commercial Member Cost-Sharing Level

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Fully- and Self-Insured
$47 PMPM in 2015
+4.4% from CY2014 to CY2015
$45 PMPM in 2014
+5.7% from CY2013 to CY2014
Link to data
Link to fact sheet
Fully-Insured
$51 PMPM in 2015
+2.5% from CY2014 to CY2015
$50 PMPM in 2014
+3.9% from CY2013 to CY2014
Self-Insured
$44 PMPM in 2015
+6.0% from CY2014 to CY2015
$41 PMPM in 2014
+7.8% from CY2013 to CY2014

Enrollment in Health Insurance

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Private Commercial
4,117,315 in March 2016
(+1.0% March 2015 to March 2016)
4,077,310 in March 2015
Link to data

Link to fact sheet
Massachusetts Public Programs 1,296,957 in March 2016
(-3.2% March 2015 to March 2016)

1,339,504 in March 2015

SCO/ One Care / PACE
57,602 in March 2016
(-0.9% March 2015 to March 2016)

58,121 in March 2015

Medicare
1,072,096 in March 2016
(+2.9% March 2015 to March 2016)
1,041,585 in March 2015

Percent of Members Whose Care is Covered by Alternative Payment Methods

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Commercial
35%
-2% pp from CY2014 to CY2015
37%
+4.4 pp from CY2013 to CY2014
Link to data

Link to fact sheet
MassHealth MCOs
32%
+0.6% pp from CY2014 to CY2015
31%
-11.1 pp from CY2013 to CY2014
MassHealth PCC
23%
+1.3% from CY2014 to CY2015
22%
+8.1 pp from CY2013 to CY2014


Massachusetts Provider Utilization and Performance

MeasureMost Recent DataPrevious DataData
Book
Additional
Data
Fact Sheet

Total Number of Patient Inpatient Discharges

Hospital Profiles FY14 Databook
(Appendix D)

792,182 in FY2014
-2.6% from FY2013 to FY2014

813,518 in FY2013
-3.1% from FY2012 to FY2013

Link to data

Link to fact sheet

Most Frequent Inpatient Discharges by Diagnostic Related Group (DRG)

Hospital Profiles FY14 Databook
(Appendix G)

FY14

Normal neonate births
(63,137)

Vaginal delivery
(46,897)

Septicemia & infections
(26,573 / +20.4%)

Cesarean delivery
(22,109)

Heart failure
(21,995 / (+3.7%)

FY13

Delivery DRGs
(132,468 / -0.3%)

Septicemia & Infections
( 22,074 / +19.5%)

Heart Failure
(21,207 / +4.3%)

Other Pneumonia
(20,688 / +3.8%)

COPD
(18,222 / +1.3%)
Link to data
Link to fact sheet

Statewide Number of Emergency Department Visits

Hospital Profiles FY14 Databook
(Appendix D)

3,035,718
in FY2014
3,062,912
in FY2013
Link to data
Link to fact sheet

Statewide Unplanned Readmission Rate

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15.3%
in 2014
15.2%
in 2013
Link to data
Link to fact sheet

Median Hospital Total Margin (Statewide)

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3.7%
in 2015
4.2%
in 2014
Link to data
Link to fact sheet

Relative Price

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 N/A  N/A  Link to data Link to fact sheet