Relative Price and Provider Price Variation

Overview

CHIA reports annually on provider price variation in Massachusetts. The relative price (RP) metric facilitates comparison of average provider prices while accounting for differences in patient illness severity (acuity), the types of services delivered to patients, and the different insurance product types (e.g., HMO, PPO) that payers offer. Data comes from private and public health care payers operating in the Massachusetts health care market.

CHIA released relative price results with data through CY 2023 for Massachusetts hospitals and physician groups. CHIA has also produced an interactive Tableau dashboard allowing users to explore the data in more detail.

Report Materials (August 2025)

Executive Summary (PDF) Databook (Excel) Technical Appendix (PDF) Methodology Report (PDF)

Key Findings

45.9%

of all health insurance payments are received by hospitals in the highest-priced quartile.

Almost 25% below

The lowest-paid acute hospital had commercial prices almost 25% below average compared with the highest-paid acute hospital, which had prices nearly double the average.

All 4 acute care hospitals

in the Cape and Islands region had above-average cross-payer relative prices.

Highest median S-RP (1.12)

at academic medical centers (AMCs)

This figure indicates that AMCs had prices about 12 percent above the statewide average. Community hospitals, teaching hospitals, and community-high public payer (HPP) hospitals had median prices 6% to 8% below the statewide average.

Continued growth

among top quartile of highest-RP clinicians

The share of payments going to the quartile of providers with the highest RPs continued to grow, increasing by 8.5 percentage points to 55% of payments from 2021 to 2023.

Interactive Dashboard

Additional Information

For chronic care, rehabilitation, and behavioral health hospitals (including private psychiatric hospitals, substance use disorder facilities, and dedicated behavioral health units within acute hospitals), CHIA calculates payer-specific RP, which enables comparison of provider prices within a payer’s network of hospitals that provide similar services. Payer-specific RP is also calculated for physician organizations.

For acute hospitals, in addition to payer-specific RP, CHIA calculates cross-payer statewide relative price (S-RP), which enables comparison of acute hospital prices across all commercial payers.

Data does not exist for all combinations of filter selections in the interactive dashboard. Where no data exists, an intentionally blank page will appear. Hospital cohorts are mutually exclusive and include academic medical centers, community hospitals, community-high public payer hospitals, teaching hospitals, and specialty acute hospitals. S-RP results for specialty acute hospitals are not shown; these hospitals are not comparable because of their unique patient populations and/or services. See the methodology report for more detailed information.

Note: Massachusetts Hospital Profiles provide descriptive and comparative information on acute and non-acute hospitals. Relative price levels for the top 3 payers at each hospital are included among the points of comparison.

Previous Publication Materials

Relative Price (RP) Data Submissions

Find submission requirements and instructions for health insurance payers reporting relative price data to CHIA, including filing specifications and deadlines.

Hospital Profiles

View standardized performance profiles for Massachusetts acute and non-acute hospitals, including financial metrics, utilization data, and operational indicators by fiscal year.