Quality of Care in the Commonwealth

CHIA monitors and reports on health care quality using measures selected from the Commonwealth's Aligned Measure Set (“Measure Set”)—a set of quality measures for voluntary adoption by private and public payers and providers, specifically for use in global budget-based risk contracts—which aims to reduce administrative burden and focus quality improvement efforts on meaningful and high priority measures. CHIA’s 2025 Annual Report includes performance on 21 of the 30 measures that comprise the 2023 Aligned Measure Set. Because not all of the 30 measures in the set will be used in contracts, CHIA’s reporting focuses on only those measures included in risk contracts, as data is available.

To date, hospital-based measures have not been considered for inclusion in the Aligned Measure Set because global budget-based contracts may not include measures specific to hospital care. However, acknowledging the importance of hospital quality measurement and transparency in health care system monitoring, CHIA also reports select hospital quality measures. The metrics included in CHIA’s quality reporting cross different domains of quality assessment, including:

• Clinical quality
• Primary care patient experience
• Statewide hospital readmissions trends
• Hospital patient experience
• Maternity-related care
• Hospital adherence to nursing workforce and hand hygiene standards
• Payer adherence to Aligned Measure Set in global budget contracts   

CHIA calculates quality performance on all-payer adult acute hospital readmissions by applying a standard methodology to the Massachusetts Hospital Inpatient Discharge Database. This measure is reported in CHIA’s Hospital-Wide Adult All-Payer Readmissions report.

For more information about the Commonwealth’s Aligned Measure Set, please visit the EOHHS Quality Measure Alignment Taskforce webpage and CHIA's interactive report on Quality Catalog Survey results.

Key Quality of Care in the Commonwealth Findings from CHIA's Annual Report (March 2025)

• Most HEDIS scores were similar from 2022 to 2023, but some measures in the Chronic Condition Care domain improved notably, including a 6.6-point increase for Controlling High Blood Pressure.

• The adult acute hospital readmission rate was 16.0% in SFY 2023, consistent with previous years. The readmission rate for commercially insured patients has been increasing for the past several years.

• Patients rated their experiences with primary care providers highest for communication with providers and lowest for questions related to support with self-managing their health, consistent with prior years.

• Five of the 32 reporting Massachusetts acute care hospitals achieved the Leapfrog Group’s maternity care standard, which recommends that no more than 23.6% of women with low-risk pregnancies deliver via cesarean section.

CHIA Focus on Provider Quality Interactive Data (Updated September 2021)