New! Primary care comprises an array of vital services, that can meaningfully shape patient outcomes and is foundational to a well-performing Massachusetts health care system. However, comprehensive data on expenditures for these services has been limited. As part of its efforts to inform policy initiatives and promote delivery system reforms and investment in primary care, CHIA collects data on payments made by health plans to health care providers delivering primary care services.
This report focuses on spending for primary care services for members enrolled in private commercial, Medicaid MCO/ACO-A, and Medicare Advantage plans for calendar year (CY) 2021.
Please note that the CY 2021 primary care data presented in this report cannot be compared to CHIA’s previous primary care reporting due to differences across data collection periods.
In September 2022, CHA produced a baseline report, databook and an interactive expenditures dashboard covering CY2018, CY2019 and CY2020 PCBH Expenditures Data as part of a reporting series on health care expenditures. The report series and dashboard will be instrumental in supporting future policy initiatives and providing insight into the Commonwealth’s investment in primary care and behavioral health.
The initial dashboard tab provides an overview Total Primary Care and Behavioral Health Expenditures by Insurance Category for the three most recent years of data - CY2018, CY2019, and CY2020. The drilldown dashboard allows users to view total spending by service type and service category. You can also choose to filter the data by calendar year, insurance category, and pediatric indicator (whether the majority of attributed patients to a physician group are younger than 18). There is also an option to exclude OBGYN services from Primary Care as well as exclude BH Prescription Drug services from Behavioral Health (to see totals inclusive of these services, use the '(All)' option.
Updated September 2022