Massachusetts Primary care AND BEHAVIORAL HEALTH SPENDING:
CY 2021 and CY2022 Report
Primary care and behavioral health comprise an array of vital services that can meaningfully shape patient outcomes and is foundational to a well-performing Massachusetts health care system. However, comprehensive spending data for these services has been limited. As part of its efforts to inform policy initiatives, investments, and delivery system reforms, CHIA collects data on payments made by health plans to health care providers, including the amounts paid by the payer as well as member-cost sharing, delivering primary care and behavioral health services.
This report focuses on spending for primary care and behavioral health services for members enrolled in private commercial, Medicaid MCO/ACO-A, and Medicare Advantage plans for calendar years (CY) 2021 and 2022.
In the most recent primary care and behavioral health data collection cycle, CHIA began collecting spending and diagnosis prevalence for mental health and substance use disorders (SUD) services separately; however, combined spending on these two service categories represents total behavioral health expenditure figures referenced in this report. Additional analyses in this report include primary care and behavioral health spending metrics by age group, payer, and managing physician group.
Please note that the primary care and behavioral health data presented in this report cannot be compared to CHIA’s previous primary care reporting due to differences across data collection periods.
