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. This page was last updated: September 26, 2017.

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
(Learn More)

$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
(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-Insured Premiums
$464 PMPM in CY2016
+2.6% from CY2015 to CY2016
$453 PMPM in CY2015
+1.8% from CY2014 to CY2015
Link to data
Link to fact sheet
Self-Insured Premium Equivalents
$504 PMPM in CY2016
+3.0% from CY2015 to CY2016
$490 PMPM in CY2015
+4.6% from CY2014 to CY2015

Commercial Health Insurance Benefit Levels (Actuarial Values)

(Learn More)

Fully- and Self-Insured
0.894 in 2016
0.903 in 2015
Link to data
Link to fact sheet
Fully-Insured
0.858 in 2015
0.875 in 2015
Self-Insured
0.925 in 2015
0.925 in 2015

Average Commercial Member Cost-Sharing Level

(Learn More)

Fully- and Self-Insured
$49 PMPM in 2016
+4.4% from CY2015 to CY2016
$47 PMPM in 2015
+5.2% from CY2014 to CY2015
Link to data
Link to fact sheet
Fully-Insured
$55 PMPM in 2016
+5.3% from CY2015 to CY2016
$52 PMPM in 2015
+1.6% from CY2014 to CY2015
Self-Insured
$44 PMPM in 2016
+3.2% from CY2015 to CY2016
$43 PMPM in 2015
+8.4% from CY2014 to CY2015

Enrollment in Health Insurance

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Private Commercial
4,072,374
in March 2017
(-0.5% March 2016 to March 2017)
4,092,028
in March 2016
Link to data

Link to fact sheet
MassHealth (Direct) and Other MA Public Programs 1,297,434
in March 2017
(-2.0% March 2016 to March 2017)

1,323,414
in March 2016

SCO, One Care, PACE
66,983 in March 2017
(+15.9% March 2016 to March 2017)

57,774
in March 2016

Medicare
1,087,321
in March 2017
(+1.9% March 2016 to March 2017)
1,067,104
in March 2016

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 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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3.1%
in 2016
3.7%
in 2015
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.