CHIA Reports on Provider Price Variation in the Commonwealth

DATE: August 31, 2022

CHIA has published its annual update on provider price variation in the commercial health insurance market. Relative price (RP) facilitates the comparison of average provider prices accounting for differences in patient acuity, the types of services providers deliver to patients, and the different insurance product types that payers offer to their members. This publication also includes an interactive dashboard including data on cross-payer statewide-relative price (S-RP) results and payer-specific RP results.

This update encompasses data through calendar year 2020 for acute care hospitals and calendar years 2019 and 2020 for physician groups within the commercial market.

KEY FINDINGS:

• In 2020, $10.4 billion was paid to acute care hospitals in Massachusetts for inpatient and outpatient services provided to patients with commercial insurance plans.

• Academic Medical Centers received the largest portion of commercial payments statewide at 41.2%, while teaching hospitals received the lowest at 12.1%. 

• Among physician groups, many payers reported a narrower range of RP values in 2020 than in 2019, potentially representative of more payments close to the network medians in 2020, and reduced impact from outlier values.

This publication includes an executive summary, interactive graphics, an analytic databook including data on S-RP for acute hospitals and payer-specific RP, as well as a technical appendix and methodology report.

For more information on provider price variation, visit CHIA's website at https://www.chiamass.gov/relative-price-and-provider-price-variation.