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 2024 for Massachusetts hospitals and physician groups. CHIA has also produced an interactive Tableau dashboard allowing users to explore the data in more detail.

Key Findings

$12.7 billion

payments to acute hospitals

In 2024, acute care hospitals received nearly $13 billion in payments from private commercial payers. The majority of payments went to hospitals in the top quartile of statewide relative price (S-RP) values.

33

acute hospitals within 10% of median S-RP

Among the 59 acute hospitals with a calculated commercial S-RP, about half were relatively close to the statewide median.

1.10

average S-RP for academic medical centers

Community hospitals, including those with a high public payer mix, had commercial S-RPs below the average of 1.00 while academic medical centers had commercial S-RPs above that average.

57%

share of commercial payments to providers with RPs in highest quartile

Among physician groups, more than half of commercial payments in 2024 went to providers in the the highest quartile of RP values, an increase from prior years.

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 Publications