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Research Brief: Affordability Issues Persist Despite Near Universal Health Insurance Coverage: Findings from the Massachusetts Health Insurance Survey (April 2019)

CHIA's Affordability Issues Persist Despite Near Universal Health Insurance Coverage: Findings from the Massachusetts Health Insurance Survey

Massachusetts has had near universal health insurance coverage since implementing the state’s 2006 health care reform law with additional coverage gains attained under the Affordable Care Act in 2014. However, Massachusetts has historically had health care costs that exceed national averages, making affordability a challenge for many Massachusetts residents despite their insurance coverage.

This brief documents the scope of health care affordability issues among Massachusetts residents with health insurance coverage all year (referred to as insured residents) and the rates of affordability issues for population subgroups.

FY 2017 Hospital Readmissions Profiles (March 2019)

CHIA's March 2019 Hospital-specific readmissions profiles

Hospital-specific readmissions profiles offers key insights into the performance of each of the 58 acute care hospitals in Massachusetts through the most recently available fiscal year (SFY 2017).

 

Each profile highlights a hospital's readmission rate over time, as well as rates broken out by patient and discharge characteristics, including age, payer type, and discharge setting. Additionally, discharge diagnoses resulting in high numbers and rates of readmissions are identified, readmissions among frequent hospital users are profiled, and readmissions to other hospitals are quantified.

Enrollment Trends (February 2019)

CHIA's February 2019 edition of Enrollment Trends

This edition of Enrollment Trends offers new insights into changes in health insurance coverage in Massachusetts from September 2016 through September 2018. Coverage is defined as unique Massachusetts residents with primary, medical membership in the 14 largest commercial payers, MassHealth (Medicaid), and Medicare.

 

Included in the February 2019 edition of Enrollment Trends are a databook, technical appendix, and Massachusetts All-Payer Claims Database (MA APCD) programming code.


 

 


Other Recent CHIA Reports and Publications

Hospital-Wide Adult All-Payer Readmissions in Massachusetts: SFY 2011-2017 (December 2018)
Go to Hospital-Wide Adult All-Payer Readmissions in Massachusetts: SFY 2011-2017 Web Page

In this year's report, CHIA found that the statewide all-payer readmission rate continued to increase from SFY 2013 to SFY 2017. Readmission rates varied greatly, depending on payer type, patient age, and discharge setting. Consistent with CHIA’s previous analyses, this report's findings suggest potential opportunities to focus efforts on the subset of patients who are frequently hospitalized.

Massachusetts Hospital Profiles (December 2018)
Massachusetts Hospital Profiles Web Page

Massachusetts Hospital Profiles provide descriptive and comparative information on acute and non-acute hospitals based on hospital characteristics, services, payer mix, utilization trends, cost trends, financial performance, and quality over a five year period. The FY 2017  publication  includes  an individual  profile  for each acute hospital,  a consolidated  profile  for each acute and non-acute hospital cohort, and a comprehensive databook.  Additionally, and new for FY2017, there is an interactive dashboard for all acute hospitals. The interactive dashboard allows users to select data views by individual hospital, hospital type, and hospital health system.

Annual Report on the Performance of the Massachusetts Health Care System (September 2018)
2018 Performance of the Massachusetts Health Care System Report report page

The 2018 Annual Report on the Performance of the Massachusetts Health Care System includes a final calculation of the Commonwealth’s 2016 Total Health Care Expenditures (THCE) and an initial calculation of 2017 THCE.

THCE is a measure of total statewide health care spending in the Commonwealth. The report also includes information from public and private sources related to specific health care expenditures for Massachusetts residents, quality of care, enrollment and coverage trends, premiums and member cost-sharing, and payer use of funds.

Rx Drug Use and Spending Report (August 2018)
Massachusetts Prescription Drug Use and Spending Report report page

The Center for Health Information and Analysis  released its first report on prescription drug use and spending in an effort to shine a light on the drivers of pharmacy spending, including high volume and high cost drugs.

 

The report concentrates on the top 10 therapeutic classes of drugs, as ranked by total expenditures incurred during fiscal year 2015. These classes accounted for 71.3% of pharmacy expenditures during that time period. In addition to presenting average costs by therapeutic class, the report contains detailed pages for each class, showing average costs for the top five most frequently prescribed drugs within the class.

 

August 2018 Enrollment Trends (August 2018)
Massachusetts August 2018 Enrollment Trends Update Report report page

Enrollment Trends offers new insights into changes in health insurance coverage in Massachusetts from March 2016 through March 2018. For the first time, this edition includes enrollment data for MassHealth Accountable Care Organizations (ACOs).

Enrollment Trends also includes a databook, technical appendix, and Massachusetts All-Payer Claims Database (MA APCD) programming code. The databook has additional detail not included in the main report.

Massachusetts FY 2017 Annual Acute Hospital and
Health System Financial Performance Report
Massachusetts FY 2017 Annual Acute Hospital and Health System Financial Performance Report report page

The Center for Health Information and Analysis (CHIA) is excited to announce the release of Massachusetts Acute Hospital and Health System Financial Performance for Fiscal Year 2017

The report presents data for the most recently completed full fiscal year available and analyses of financial performance using five metrics: total margin, operating margin, current ratio, average payment period, and equity financing. It also includes a comparison of the performance of four hospital cohorts (Academic Medical Centers, teaching, community, and community-High Public Payer) on each metric over a four-year period, Fiscal Years 2014 through 2017.

Hospital-Wide Adult All-Payer Readmissions in Massachusetts:
SFY 2011-2016 (June 2018)
Click to visit Hospital-Wide Adult All-Payer Readmissions in Massachusetts: SFY 2011-2016 report page

In this year’s report, CHIA found that the statewide all-payer readmission rate remained steady from SFY 2015 to the SFY 2016. Readmissions continued to vary greatly, however, depending on patient age, payer type, and discharge setting. Consistent with CHIA’s previous analyses, this report's findings suggest potential opportunities to focus efforts on the subset of patients who are frequently hospitalized.

Individual Purchasers in the Massachusetts Health Care System:
Trends for Unsubsidized and ConnectorCare Plans (May 2018)
Individual Purchasers in the Massachusetts Health Care System report page

Individual Purchasers in the Massachusetts Health Care System: Trends for Unsubsidized and ConnectorCare Plans.  explores trends in premiums and cost-sharing related to individuals purchasing commercial health plans outside the employer-sponsored insurance system, as well as the role of cost-sharing reduction subsidies.

CHIA found that, overall, the individual purchaser market segment experienced decreases in average premiums (-3.4%) and cost-sharing (-8.0%) between 2015 and 2016. CHIA also found that unsubsidized plans experienced higher premium growth and larger cost-sharing increases than ConnectorCare Plans.

Hospital-Wide Adult All-Payer Readmissions (May 2018)
Picture of Massachusetts Readmissions information

CHIA's latest analysis of unplanned hospital readmissions in Massachusetts. Hospital-Wide Adult All-Payer Readmissions in Massachusetts: SFY 2011-2016 updates previous CHIA reporting on the subject.

In this year’s report, CHIA found that the statewide all-payer readmission rate remained steady from SFY 2015 to the SFY 2016. Readmissions continued to vary greatly, however, depending on patient age, payer type, and discharge setting. Consistent with CHIA’s previous analyses, this report's findings suggest potential opportunities to focus efforts on the subset of patients who are frequently hospitalized.

Pediatric Home Care Patients Study Outside Section 132 (May 2018)
Picture of Massachusetts State House

The Center for Health Information and Analysis completed a study of the costs associated with the hospitalization of medically complex pediatric home care patients, in accordance with Section 132 of Chapter 47 of the Acts of 2017.