CHIA Standard Statistics


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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. This page was last updated: January 13, 2020.

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)

$8,663 per capita
+2.8% from CY2015 to CY2016
$8,429 per capita
+4.8% from CY2014 to CY2015
Link to data

Link to fact sheet

Total Medical Expenses for Commercially-Insured Members
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$466 PMPM in 2016
+3.4% from CY2015 to CY2016
$451 PMPM in 2015
+2.7% from CY2014 to CY2015
Link to data

Link to fact sheet
Insurance Rate of Massachusetts Residents
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96.3% in 2016

96.4% in 2015
Link to data
Link to fact sheet

Percent of Massachusetts Employers Offering Health Insurance

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71% in 2018
65% in 2016
Link to data
Link to fact sheet

Average Cost of Commercial Coverage

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Fully-Insured Premiums
$483 PMPM in CY2017
+4.9% from CY2016 to CY2017
$460 PMPM in CY2016
+2.0% from CY2015 to CY2016
Link to data
Link to fact sheet

Commercial Health Insurance Benefit Levels (Paid-to-Allowed Claims Ratio)

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Fully- and Self-Insured
0.879 in 2017
0.895 in 2016
Link to data
Link to fact sheet
Fully-Insured
0.880 in 2017
0.887 in 2016
Self-Insured
0.879 in 2017
0.901 in 2016

Average Commercial Member Cost-Sharing Level

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Fully- and Self-Insured
$52 PMPM in 2017
+5.7% from CY2016 to CY2017
$49 PMPM in 2016
+4.3% from CY2015 to CY2016
Link to data
Link to fact sheet
Fully-Insured
$57 PMPM in 2017
+7.6% from CY2016 to CY2017
$53 PMPM in 2016
+4.8% from CY2015 to CY2016
Self-Insured
$47 PMPM in 2017
+4.2% from CY2016 to CY2017
$45 PMPM in 2016
+3.4% from CY2015 to CY2016

Enrollment in Health Insurance

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Private Commercial
4,062,404 in March 2019
(+0.7% March 2018 to March 2019)
4,035,330 in March 2018
Link to data

Link to fact sheet
MassHealth (Direct) 1,183,141 in March 2019
(-6.1% March 2018 to March 2019)

1,260,580 in March 2018

SCO, One Care, PACE
87,631 in March 2019
(+12.9% March 2018 to March 2019)

77,633 in March 2018

Medicare
1,102,761 in March 2019
(+1.5% March 2018 to March 2019)
1,086,856 in March 2018

Percent of Members Whose Care is Covered by Alternative Payment Methods

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Commercial
42.0%
+6.3 pp from CY2015 to CY2016
35.7%
-1.3 pp from CY2014 to CY2015
Link to data

Link to fact sheet
MassHealth MCOs
35.7%
-0.9 pp from CY2015 to CY2016
36.6%
+2.4 pp from CY2014 to CY2015
MassHealth PCC
23.5%
+0.5 pp from CY2015 to CY2016
23.0%
+1.4 pp from CY2014 to CY2015


Massachusetts Provider Utilization and Performance

MeasureMost Recent DataPrevious DataData
Book
Additional
Data
Fact Sheet

Total Number of Patient Inpatient Discharges

Hospital Profiles FY18 Databook
(Appendix E)

813,618 in FY2018
-0.2% from FY2017 to FY2018
815,131 in FY2017
+0.9% from FY2016 to FY2017
Link to data

Link to fact sheet

Most Frequent Inpatient Discharges by Diagnostic Related Group (DRG)

Hospital Profiles FY18 Databook
(Appendix H)

FY18

Normal Neonate Births
(60,761 / -0.8%)

Vaginal Delivery
(45,348 / -1.3%)

Septicemia & Infections
(35,371 / +6.0%)

Heart Failure
(26,893 / +4.0%)

Cesarean Delivery
(21,757 / -0.3%)

FY17

Normal Neonate Births
(61,267 / -0.8%)

Vaginal Delivery
(45,951 / -1.4%)

Septicemia & Infections
(33,369 / -1.4%)

Heart Failure
(25,863 / +7.9%)

Cesarean Delivery
(21,831 / +0.3%)
Link to data
Link to fact sheet

Statewide Number of Emergency Department Visits

Hospital Profiles FY18 Databook
(Appendix E)

3,146,507
in FY2018
3,144,308
in FY2017
Link to data
Link to fact sheet

Statewide Unplanned Readmission Rate

(Learn More)

15.4%
in 2018
15.4%
in 2017
Link to data
Link to fact sheet

Median Hospital Total Margin (Statewide)

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4.5%
in 2018
3.2%
in 2017
Link to data
Link to fact sheet

Relative Price

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