Quality of Care in the Commonwealth

CHIA monitors and reports on health care quality using measures selected from the Commonwealth's Aligned Measure Set (“measure set”)—a set of quality measures for voluntary adoption by private and public payers and providers, specifically for use in global budget-based risk contracts—which aims to reduce administrative burden and focus quality improvement efforts on meaningful and high priority measures. CHIA’s 2024 Annual Report includes performance on 21 of the 35 measures that comprise the 2022 Aligned Measure Set . Note that as it is not expected that all 35 measures in the set will be used in contracts, CHIA’s reporting focuses on those measures that are included in risk contracts, as data is available.

To date, hospital-based measures have not been considered for inclusion the Aligned Measure Set because global budget-based contracts may not include measures specific to hospital care. However, acknowledging the importance of hospital quality measurement and transparency in health care system monitoring, CHIA also reports select hospital quality measures. The metrics included in CHIA’s quality reporting cross different domains of quality assessment, including:

• Clinical Quality Measures
• Hospital patient experience
• Primary care patient experience
• Maternity-related care
• Hospital adherence to nursing workforce and hand hygiene standards
• Payer Adherence to the Aligned Measure Set in global budget contracts

CHIA calculates quality performance on all-payer adult acute hospital readmissions by applying a standard methodology to the Massachusetts Hospital Inpatient Discharge Database. This measure is reported in CHIA's Annual Report on the Performance of the Massachusetts Health Care System.

For more information about the Commonwealth’s Aligned Measure Set, please visit the EOHHS Quality Measure Alignment Taskforce webpage and CHIA's interactive report on Quality Catalog Survey results.

Key Quality of Care in the Commonwealth Findings from CHIA's Annual Report (March 2024)

• Performance on clinical quality metrics improved in 2022 compared to 2020 for all Pediatric/Adolescent care measures with data available for both years, including a 20-point increase for Adolescent Immunizations.

• Commercial member-reported ratings of their experiences with primary care providers in the domain of Adult Behavioral Health improved 3.0 points from 2021 to 2022—the largest point change during the period.

• The adult readmission rate in SFY 2022 was 15.8%, declining slightly from 16% in 2021; heart failure, sepsis, and major respiratory infections remained the most common diagnoses for readmissions.

• Eight of 32 reporting acute care hospitals in Massachusetts achieved all three Leapfrog standards for reducing unnecessary maternity- related procedures in 2022.

CHIA Focus on Provider Quality Interactive Data (Updated September 2021)