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.
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.
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.