DataMatters - July 2021 Edition
In this Issue:
Opening Message
If you’re not lucky enough to be on vacation right now, may you find temporary repose catching up with CHIA’s recent reports and data asset updates in this issue of DataMatters. This month’s issue features the latest snapshots of our data users. See “News You Can Use” to learn about the agency’s first report documenting unmet health-related social needs using the Massachusetts Health Insurance Survey, or our “Data User Profile,” which features a Texas-based research team that used CHIA's hospital discharge data to inform their just-published study, Emergency Department Utilization by Adolescents Experiencing Homelessness in Massachusetts. CHIA also recently published reviews of mandated health insurance benefits in the Commonwealth, hospital and health system financial data, and an examination of provider price variation using Relative Price.
DataMatters is a newsletter for you – all stakeholders interested in the data we collect, release, and report on. We hope you will enjoy reading and learn something new. We also want to hear your opinions on what you’ve read and what you’d like to see in our next issue. Please let us know by emailing newsletter@chiamass.gov.
News You Can Use
CHIA expanded the scope of reporting from its Massachusetts Health Insurance Survey (MHIS) last month to include a new area of study – Social Determinants of Health – with the research brief Over Half of Massachusetts Residents Report Unmet Health-Related Social Needs in Their Families. The MHIS is a Massachusetts household survey fielded every other year. The Unmet Health-Related Social Needs (HRSN) research brief documents the prevalence of unmet HSRNs in Massachusetts. Residents who reported food insecurity, housing instability, financial strain, or employment instability in their families were considered to have an unmet HRSN. The research brief found that the majority (52%) of all Massachusetts residents reported at least one unmet HRSN in their families in 2019, and over one-third (34%) reported multiple unmet HRSNs. Unmet HRSNs were experienced by residents and their families at all income levels, across race/ethnicity groups, and across all family types. However, residents with very low or low income, residents of color, and residents in single-parent families experienced unmet HRSNs at significantly higher rates than their counterparts. The full brief contains more details on the findings. It is CHIA’s first step to document the burden of unmet HRSNs in Massachusetts and better understand how they are experienced by residents and their families across the state.
Data User Profile
Each edition of DataMatters features an interview with a recent user of CHIA data, focusing on their experience obtaining and using the data in addition to research outcomes. We are grateful to Drs. Hye-Chung Kum, of Texas A&M University, and Theodoros Giannouchos, of University of Utah College of Pharmacy, who shared their experiences using CHIA’s Case Mix Emergency Department data (via the Healthcare Cost and Utilization Project, or HCUP, a national discharge database maintained by the U.S. Agency for Healthcare Research and Quality) to inform their April 2021 Medical Care publication, Emergency Department Utilization by Adolescents Experiencing Homelessness in Massachusetts (with additional authors). Note: Responses lightly edited for space.
Source: Findings from Emergency Department Utilization by Adolescents Experiencing Homelessness in Massachusetts, authors’ graphic created for DataMatters (with minor in-house design adjustments).
What was your research question? Why did you choose that question?
TG: Our questions were: 1) How many times more do homeless adolescents go to the Emergency Department (ED)? 2) Of those who go to the ED, what characteristics drive them there? We had been working with HCUP data for different projects, but once we got our hands on Massachusetts data, we saw that there was a homeless indicator. The homeless indicator gives researchers leverage to do novel work, present new findings and help policymakers.
HK: In my experience there are not a lot of databases that track homeless people. We were able to cross-check the indicator with ICD-9 codes and by checking with hospitals. We decided to go ahead with the paper after talking to the hospitals.
Which CHIA data did you use?
TG: We got our data, covering 2011-2016, through HCUP [DataMatters note: CHIA periodically submits Case Mix Emergency Department and Hospital Inpatient Discharge data collected from Massachusetts hospitals to HCUP].
What was your experience using CHIA data?
TG: It was pretty simple to get. You just write up a page describing your research project, apply, and HCUP makes a decision within two to six weeks. You can buy individual states, or national samples.
HK: Massachusetts is one of the few databases to have a homeless indicator. We also liked that each patient has a unique hashed (masked) identifier; you can follow and track the patients across providers and years.
Please briefly describe your research and key findings:
TG: The 10,000 homeless adolescents in our study accounted for 46,000 ED visits – about five visits per year, which was disproportionately high compared to non-homeless cohort. Another big finding at this point was that mental health and substance use disorders were really, really high for homeless adolescents compared to a non-homeless comparison group.
Which findings were especially interesting, or surprising for you?
TG: Homelessness is associated with more ED visits - the takeaway is that housing seems to be and is a separate social determinant of health. Also, we realized that more than 50% of the homeless cohort of adolescents tracked were on Medicaid.
What "takeaway" information would you like to highlight?
TG: Three main messages: 1) Housing is a separate social determinant of health; 2) The importance of having the homeless indicator in large secondary databases; 3) Providers should have assistance on-hand to refer homeless adolescents to services addressing food insecurity and housing insecurity, once they leave the ED. Also, providers should have support and training to promote non-judgmental care that these individuals need.
HK: When a homeless teen visits an ED for the first time then you can try to meet their social needs and avoid future ED visits.
Publications
Massachusetts Acute Care Hospital Inpatient Discharge Data (FFY 2016-2019): Quarterly Update
July 2021
The latest quarterly update to the Massachusetts Acute Care Hospital Inpatient Discharge Data (FFY 2016-2019) report was released this week. Using interim data, this update offers timely insights into monthly inpatient utilization patterns, discharge characteristics, diagnoses, and procedures through a series of interactive dashboards. It adds data from the latest quarter, January through March 2021, to monthly summary data available starting in October 2018. A summary and an accompanying databook are also available.
Hospital Discharge Database: Inpatient and Emergency Department, FY 2020
Summer 2021
Summer 2021
CHIA recently released hospital inpatient and emergency department discharge data (Case Mix) for FY20. Case Mix is one of CHIA’s most-requested data assets and the one that has been in production the longest. The data is also shared with the Healthcare Cost and Utilization Project (HCUP), the U.S. government national hospital discharge dataset used by researchers nationwide.
Massachusetts Acute Hospital and Health System Financial Performance Report (quarterly update for period ending March 31, 2021)
July 2021
The latest Acute Hospital and Health System Financial Performance report includes data from acute hospitals, associated health systems, and physician organizations for the period ending March 31, 2021. The period ending March 31, 2020, which is used as a comparison for the data in this report, includes the first few weeks of the impact of COVID-19 on health care operations. COVID-19 relief funding was distributed beginning in April 2020 and a portion of this funding was reported as operating revenue. Research brief: Over Half of Massachusetts Residents Report Unmet Health-Related Social Needs in Their Families (June 2021)The research brief is the first CHIA publication to focus on unmet health-related social needs (HRSNs). See the “News You Can Use” section above for highlights.
Research Brief: Over Half of Massachusetts Residents Report Unmet Health-Related Social Needs in Their Families
June 2021
The research brief is the first CHIA publication to focus on unmet health-related social needs (HRSNs). See the “News You Can Use” section above for highlights.
Relative Price Report
June 2021
Relative Price reporting is produced annually and shows variations in payments for similar health care services at different facilities. This year’s report includes data for CY2019 (for hospitals) and CY2018 (for physician groups). CHIA calculates both payer-specific RP, which enables comparison within insurer networks, and cross-payer statewide relative price (S-RP), which allows for comparison across commercial payers for acute hospitals.
Monthly Enrollment Monitoring through March 2021
June 2021
Monthly Enrollment Monitoring through March 2021 (June 2021)The latest in CHIA’s Monthly Enrollment Monitoring series covers insurance enrollment by key market sectors through March 2021. It presents a one-year retrospective on enrollment since the onset of the COVID-19 pandemic in Massachusetts in March 2020.
Mandated Benefit Reviews
Summer 2021
CHIA is responsible for evaluating the impact of pending health benefit mandate bills, as referred to the agency by the Massachusetts Legislature. These bills would require fully-insured health plans in Massachusetts to cover a particular benefit should they become law. CHIA analyzes the medical efficacy of the benefit and provides an actuarial estimate of the bill’s effect on health care costs.
CHIA recently conducted reviews a set of bills that would include abortion and abortion-related care within the coverage mandate for prenatal care, childbirth, and postpartum care and eliminate cost-sharing for all pregnancy-related services (MBR of H1196/S673, An Act ensuring access to full spectrum pregnancy care) and another that would provide coverage for fertility preservation services (An act relative to preserving fertility, H1116/S640).
CHIA also recently completed a comprehensive review of all 45 mandated health insurance benefits in effect in Massachusetts as of 2018. Under state law CHIA is required to produce such a report every four years.
Upcoming Events and Resources
CHIA Oversight Council
September 22
CHIA’s activities are guided by an 11-member Oversight Council with a wide range of experience and expertise in health care, technology, and related fields. The Oversight Council meets quarterly and meetings are live streamed and available as recordings on CHIA’s YouTube channel. An agenda for September’s meeting is forthcoming.
CHIA at NAHDO Conference
September 28-30
Staff from CHIA’s Strategies and Research Team will be presenting at the National Association of Health Data Organizations’ (NAHDO) 36th Annual conference, to be held virtually.
- Timeliness and Accessibility: Developing an Interactive Dashboard for Quarterly Updates on the Massachusetts Acute Care Hospital Inpatient Discharge Data. (Part of Spotlight Series presentations, time TBD)
- A Methodology to Identify and Analyze Hospitalizations with Behavioral Health Comorbidities: Preliminary Findings from the COVID-19 Pandemic (Session Title: Health Databases and COVID-19: Adapting the Data, Responding to Trends; Sept. 28, 3:20 p.m.)
- How does COVID-19 Impact Statewide Readmission Trends in Massachusetts? (Session Title: Adopting Methodologies to Better Track COVID-19 and other novel phenomena, Sept. 30, 12:50 p.m.)
Massachusetts Health Connector Low- or No-Cost Premiums available to Unemployed
The Massachusetts Health Connector is the state's Marketplace for health and dental insurance. Health Connector plans are open to Massachusetts individuals and families who do not have access to affordable coverage through a job, and financial assistance is available to those who qualify. Thanks to the American Rescue Plan, the COVID-19 stimulus bill passed in March, additional assistance is now available, including low- and no-cost plans to those currently receiving unemployment benefits. Click to learn more about this new benefit, or review the FAQ or this video produced by the Massachusetts Health Connector. You can also apply for or update a Health Connector account at www.MAhealthconnector.org to see if you qualify. When you apply, include information about your unemployment benefits so the Health Connector can check to see if you qualify.
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