Annual Report on the Performance of the Massachusetts Health Care System: 2019

2019 Annual Report





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The 2019 Annual Report on the Performance of the Massachusetts Health Care System includes a final calculation of the Commonwealth’s 2017 Total Health Care Expenditures (THCE) and an initial calculation of 2018 THCE. THCE is a measure of total statewide health care spending in the Commonwealth.

The report includes information from public and private sources related to specific health care expenditures for Massachusetts residents, quality of care in the Commonwealth compared to national performance, enrollment and coverage trends, premiums and member cost-sharing, and payer use of funds.

This report informed the Health Policy Commission’s 2019 Health Care Cost Trends Hearing, which was held on October 22 and 23, 2019.

Key Findings

    • THCE totaled $60.9 billion in 2018, or $8,827 per capita; this represents an increase of 3.1% from 2017, equal to the health care cost growth benchmark.

    • Hospital services, physician, and pharmacy expenditures continued to be the largest service categories of THCE spending.

    • Pharmacy spending totaled $9.9 billion in 2018, a 5.8% increase from 2017. Net of prescription drug rebates, pharmacy spending was $8.1 billion, an increase of 3.6% from the prior year.

    • The proportion of commercial members enrolled in high deductible health plans (31.5%) continued to increase across most market sectors in 2018.

    • Commercial member cost-sharing and premiums continued to increase at a faster rate than wages and inflation.

    • Adoption of APMs increased within MassHealth in 2018 with the rollout of ACOs.

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