Health Care Costs & Payments

CHIA examines health care cost and payment trends through a variety of methods. Our broadest look at health care spending is under a combined heading of Total Health Care Expenditures, Total Medical Expenses and Alternative Payment Methods.

Our Commercial Insurance: Premiums and Member Cost Sharing research shows trends in both total cost to health plan members and changes in the quality of the benefits over time. Cost-sharing research and data is also included in findings from CHIA’s Massachusetts Health Insurance Surveys (MHIS). The survey findings reflect the impacts of medical costs on Massachusetts households with all forms of insurance coverage (including private commercial, MassHealth, and Medicare) as well as the uninsured.

Relative Price and Price Variation is a calculated measure that compares different provider prices within a payer’s network for a standard mix of insurance products (e.g. HMO, PPO, and Indemnity) to the average of all providers’ prices in that network. Commercial payers’ prices for similar services vary considerably among Massachusetts hospitals.

Primary care and behavioral health care (PCBH) comprise an array of vital services that can meaningfully shape patient outcomes and are often associated with lower health care costs and higher quality. CHIA's has reported on spending for primary care services for members enrolled in private commercial, Medicaid MCO/ACO-A, and Medicare Advantage plans.


Health care cost and payment trends are related to a variety of other factors, including utilization and population health. A broad group of these topics are brought together in our look at overall Health System Performance and in our Hospital Profiles sections of the website