Total Health Care Expenditures


Total Health Care Expenditures (THCE) Metric

THCE is a measure of total statewide spending for health care in the Commonwealth, and includes: 

  • All categories of medical expenses paid to providers

  • All non-claims related payments to providers , such as performance payments

  • Member cost-sharing payments to providers, such as deductibles, co-payments, and co-insurance

  • The Net Cost of Private Health Insurance

 

It is divided by the Massachusetts population to give a per-capita measure of total health care expenditures.


THCE Data

CHIA collects the medical claims, non-claims, and member cost-sharing payment information from commercial and public payers.

Payer data submissions are not available as a public record.

Remaining data components are reported by public programs, or calculated based on actuarial estimates.



THCE Methodology 2017 (PDF)
| Word

 

 

For More Information on Total Health Care Expenditures,
see CHIA's 2017 Annual Report

chia annual report 2017 cover

The Center for Health Information and Analysis (CHIA) is tasked with calculating Total Health Care Expenditures (THCE) and comparing growth with the health care cost growth benchmark set by the Health Policy Commission. THCE includes health care expenditures for Massachusetts residents from public and private sources. The establishment of the THCE measure is a key provision of the 2012 Massachusetts health care cost containment law, Chapter 224 of the Acts of 2012. The Health Policy Commission set the health care cost growth benchmark at +3.6%.

Each year, CHIA publishes an initial assessment of THCE based on data submitted five months after the close of the calendar year, including payers’ estimates for claims completion and quality and performance settlements. Final THCE is published the following year, based on final data which is submitted seventeen months after the performance year.

 

Key Findings from the 2017 Annual Report

  • THCE totaled $59.0 billion in 2016, or $8,663 per capita. This represents an increase of 2.8% from 2015, below the health care cost growth benchmark.

 

    • Overall spending increased across all major insurance categories, but at more moderate rates than in prior years, and declined for the net cost of private health insurance.

 

    • Pharmacy and hospital outpatient spending were the largest drivers of THCE growth.

 

Total Health Care Expenditures in Massachusetts

 

Previous Total Health Care Expenditures Publication Materials