CHIA Standard Statistics


Questions

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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
(Learn More)

$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
(Learn more)

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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65% in 2016
(See footnote) *
Link to data
Link to fact sheet

Average Cost of Commercial Coverage

(Learn More)

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

(Learn More)

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
4,154,323 in September 2016
(+0.9% September 2015 to September 2016)
4,115,296 in September 2015
Link to data

Link to fact sheet
MassHealth (Direct) and Other MA Public Programs 1,313,480 in September 2016
(+0.1% September 2015 to September 2016)

1,312,052 in September 2015

SCO, One Care, PACE
61,134 in September 2016
(+1.0% September 2015 to September 2016)

60,527 in September 2015

Medicare
1,085,065 in September 2016
(+2.8% September 2015 to September 2016)
1,055,519 in September 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 FY15 Databook
(Appendix H)

808,410 in FY2015
+2.0% from FY2014 to FY2015
792,182 in FY2014
-2.6% from FY2013 to FY2014

Link to data

Link to fact sheet

Most Frequent Inpatient Discharges by Diagnostic Related Group (DRG)

Hospital Profiles FY15 Databook
(Appendix H)

FY15

Normal Neonate Births
(60,806 / -3.7%)

Vaginal Delivery
(46,743 / -0.3%)

Septicemia & Infections
(32,772 / +23.3%)

Heart Failure
(23,670 / +7.1%)

Cesarean Delivery
(21,807 / -0.9%)

FY14

Normal Neonate births
(63,137)

Vaginal Delivery
(46,897)

Septicemia & Infections
(26,573)

Cesarean Delivery
(22,109)

Heart Failure
(21,995)
Link to data
Link to fact sheet

Statewide Number of Emergency Department Visits

Hospital Profiles FY15 Databook
(Appendix E)

3,042,611
in FY2015
3,035,718
in FY2014
Link to data
Link to fact sheet

Statewide Unplanned Readmission Rate

Learn More

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

 

* In 2016, the Massachusetts Employer Survey sample was redesigned to capture responses from firms (e.g., CVS Pharmacy as an organization) rather than establishments (e.g., an individual CVS Pharmacy worksite), as decision making about health benefits is almost always made at the firm rather than the establishment level. Such change has made comparisons to data from previous surveys more complex. For details, please see the 2016 Summary of Results  and the 2016 Field Report.