Health Care Costs & Payments

CHIA examines health care cost and payment trends through a variety of studies. Our broadest look at spending is Total Health Care Expenditures (THCE)Total Medical Expenses (TME) is one component of THCE, and is the best way to understand spending at the health plan, physician group, and regional level. Our premiums analyses show trends in both total cost to health plan members and changes in the quality of the benefits over time.

CHIA collects and analyzes data on Massachusetts member cost sharing. Payers submit financial data by market sector, product type (HMO, PPO, POS), funding type, and benefit design type (HDHP, tiered network, limited network). Cost Sharing research and data is also included in findings from CHIA’s Massachusetts Health Insurance Surveys (MHIS).

CHIA also looks at contracting trends between providers and health plans, reporting both on price variation among providers, and on the payment methods used by health plans.

Health care cost and payment trends are related to a variety of other factors, including utilization and population health. A broad group of these topics are brought together in our look at overall Health System Performance and in our Hospital Profiles.