CHIA monitors health care spending by public and private payers in Massachusetts using three key metrics: Total Health Care Expenditures (THCE), Total Medical Expenses (TME), and alternative payment methods (APMs). These measures are all reported in CHIA's Annual Report on the Performance of the Massachusetts Health Care System.
Primary care and behavioral health care (PCBH) comprise an array of vital services that can meaningfully shape patient outcomes and are often associated with lower health care costs and higher quality. CHIA's latest report, released in October 2023, focuses on spending for primary care services for members enrolled in private commercial, Medicaid MCO/ACO-A, and Medicare Advantage plans for calendar year 2021. CHIA's baseline report on primary care and behavioral health expenditures in Massachusetts, released in September 2022, focuses on spending by market level, primary care, and behavioral health. Read more....
To advance transparency into this sector of the health care market for policy makers, researchers, and the public, CHIA has recently published an interactive dashboard and detailed dataset, allowing users to see drivers of prescription drug spending as well as the associated conditions these drugs treat. Read more.....
Relative price is a calculated measure that compares different provider prices within a payer’s network for a standard mix of insurance products (e.g. HMO, PPO, and Indemnity) to the average of all providers’ prices in that network. Commercial payers’ prices for similar services vary considerably among Massachusetts hospitals. Read more...
CHIA collects annual commercial health insurance premiums and premium-equivalent data from health care payers, allowing for insights into the costs borne by both Massachusetts employers and employees. CHIA also monitors membership concentrations, premium values scaled by full benefits, and consumer cost-sharing over time. Read more...
CHIA examines Massachusetts hospital financial performance on a quarterly and annual basis to monitor each acute hospital’s financial health. Hospital performance for profitability, liquidity, and solvency metrics are published in quarterly and annual reports, and in individual hospital trend analysis. Read more
The Multi-Source Acute Hospital Financial Dataset provides an integrated dataset that combines acute hospital financial data from a variety of CHIA data assets. This consolidation of data facilitates the exploration of financial information for acute care hospitals in Massachusetts, including cost, revenue, financial performance, payer mix, utilization, and hospital characteristics. Read More....
CHIA collects detailed financial information from hospitals to increase transparency for the Commonwealth, and has improved our process of collection and distribution. Beginning with Fiscal Year 2015, Massachusetts Hospital Cost Report Data is available online. It contains details such as cost, revenue, payer mix, and utilization data. Read more