CHIA adds behavioral health data to annual report on state healthcare performance

DATE: March 14, 2023

For the first time ever, the Center for Health Information and Analysis has included sections on behavioral health in its Annual Report on the Performance of the Massachusetts Health Care System.

The Covid-19 pandemic shifted focus to behavioral health, leading CHIA to examine costs, price, quality, utilization and patient outcome for behavioral health patients in its latest report.

The center was tasked with the view by the Mental Health ABC Act: Addressing Barriers to Care.

In 2021, spending on behavioral health services was 6.6% of total health care spending for commercial members, 15.9% for Medicaid MCO/ACO-A members, and 1.9% for Medicare Advantage members, CHIA found.

Member cost-sharing for behavioral health spending was also higher compared to other services, like primary care, meaning Massachusetts residents are paying more out of pocket for mental health services.

The data also points to potential inequities among income levels for behavioral healthcare.

For example, commercial payers had lower rates of behavioral health diagnoses, compared to Medicaid MCO/ACO-A members. Meanwhile, substance use-related spending represented a third of Medicaid MCO/ACO-A behavioral health spending, compared to 17.1% for Medicare Advantage, and 12.3% for commercial plans.

The biggest takeaway from the behavioral health section, according to Lauren Peters, executive director of CHIA, is that MCO/ACO-A's have the largest portion of total spend on behavioral health as compared to Medicare and commercial. 

“We also know that their membership profiles look a little bit different," Peters said. "Part of that can be explained by the higher proportion of MassHealth members with behavioral health diagnoses, but I think that that does not explain all of it."

On Wednesday, the Health Policy Commission will host its annual hearing on the healthcare cost growth benchmark, which is a statewide spending target to hold the system accountable to keeping costs affordable. This report from CHIA, including the new section on behavioral health, will be a major tool in how the state decides limit spending in Massachusetts healthcare.

by Cassie McGrath, Boston Business Journal