Massachusetts Commercial Medical Care Spending: Findings from the All-Payer Claims Database


Key Findings

  • Medical claims-based spending increased an average 2.9% annually between 2010 and 2012; enrollment declined 2.8% per year over that same period.
  • Members’ out-of-pocket spending rose from 6.9% of medical spending to 7.7% between 2010 and 2012.
  • The fastest growing category of service was outpatient facility claims, which grew at 8% per year and made up 18% of spending in 2012.
  • Spending growth was concentrated by episode, with 10 episode types making up 44% of growth.
  • Spending per member per month (PMPM) varied from $306 in the Pioneer Valley/Franklin region to $429 in the Cape and Islands region.
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Massachusetts Commercial Medical Care Spending: Findings from the All-Payer Claims Database is a joint publication of CHIA and the Health Policy Commission (HPC). This report examines trends in commercial medical spending including overall spending trends and spending by category of service, type of episode, and region using data from the All-Payer Claims Database (APCD)


About this Publication


The data used in this chartbook publication is derived from medical claims-based payments submitted to the APCD for Massachusetts residents insured by the state’s three largest commercial payers in calendar years 2010, 2011, and 2012. The databook provides this data, along with additional results from this analysis. 

These materials enhance our understanding of the Massachusetts health care market and demonstrate our commitment to transparency and ongoing collaboration with other state agencies.

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