DATE: June 30, 2021
The Center for Health Information and Analysis (CHIA) has released its annual update of provider price variation in the Massachusetts commercial health insurance market.
The dashboard, which is available online, has been updated with data through calendar year 2019 for acute care hospitals and calendar year 2018 for physician groups. The findings examine both relative price, comparing the average provider prices, while 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 member, according to a Friday press release from CHIA.
The organization calculates both payer-specific relative price, which enables comparison within a payer’s network, and cross-payer statewide relative price, which allows for comparison across commercial payers.
“Provider price variation has a significant impact on overall health care spending, access and affordability in the Commonwealth,” said Ray Campbell, CHIA executive director, in a press release. “CHIA’s reporting on relative price promotes greater transparency across and within payers’ networks and provides stakeholders and policymakers with a better understanding of the dynamics of the Massachusetts health care system.”
Some of the findings from the update include:
In 2019, $10.8 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 amount of commercial payments statewide at 40.8%, while teaching hospitals received the lowest at 11.9%.
In 2018, $7.1 billion was paid to physician groups for services provided to patients with commercial insurance plans.
The interactive dashboard and additional supporting materials are available online.