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CHIA Standard Statistics

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Please contact CHIA regarding these measures or the information contained within the fact sheets.

This page was last updated: March 27, 2024.

CHIA maintains a  set of standard statistics that measure the performance of the Massachusetts health care system. The information in the tables below is derived from CHIA's unique data sets or other Massachusetts-specific reliable sources. The standard statistics information has two focus areas:

Spending and Insurance Coverage

Measure
Current
Data
Antecedent Data
Prior Data
Fact Sheet

Total Health Care Expenditures
(THCE)
(Learn More)
$71.7 billion in 2022
$10,264 per capita
+5.8% from 2021
(exceeds health care benchmark)
$67.8 billion in 2021
$9,715 per capita
+9.0% from 2020
(exceeds health care benchmark)
Note: 3.2% annualized from 2019 to 2021
$62.7 billion in 2020
$8,912 per capita
-2.3% from 2019
(below health care benchmark)
Total Medical Expenses for
Commercially-Insured Members
(Learn More)
$615 PMPM in 2022
+3.9%
from CY2021 to CY2022
$592 PMPM in 2020
+16.1%
from CY2020 to CY2021
 $510 PMPM in 2020
-1.9%
from CY2019 to CY2020
Insurance Rate of
Massachusetts Residents
(Learn more)
97.6 % in 2021
97.1% in 2019
96.3% in 2016

Percent of Massachusetts Employers Offering Health Insurance
(Learn More)
74% in 2021
71% in 2018
65% in 2016

Average Cost of
Commercial Coverage
(Learn More)

 Fully-Insured Premiums
$595 PMPM in 2022
+5.8%
from CY2021 to CY2022
$563 PMPM in 2021
+6.6%
from CY2020 to CY2021
$529 PMPM in 2020
+2.6%
from CY2019 to CY2020

Commercial Health
Insurance Benefit Levels
(Paid-to-Allowed
Claims Ratio)
(Learn More)
Fully-
and Self-Insured
0.891 in 2022
0.895 in 2021
0.897 in 2020

Fully-Insured
0.872 in 2022
0.880 in 2021
0.888 in 2020

Self-Insured
0.905 in 2022
0.908 in 2021
0.905 in 2020

Average Commercial
Member Cost-Sharing
Level
(Learn More)

 Fully-
and Self-Insured

$61 PMPM in 2022
+6.0%
from CY2021 to CY2022

$58 PMPM in 2021
+18.4%
from CY2020 to CY2021

$49 PMPM in 2020
-16.7%
from CY2019 to CY2020
Fully-Insured

 

$76 PMPM in 2022
+9.7%
from CY2021 to CY2022

 

$69 PMPM in 2021
+22.1%
from CY2020 to CY2021

 

 

$57 PMPM in 2020
-14.8%
from CY2019 to CY2020

 
Self-Insured
$52 PMPM in 2022
+2.8%
from CY2021 to CY2022
$51 PMPM in 2021
+15.7% from CY2020 to CY2021

 

$44 PMPM in 2020
-17.4%
from CY2019 to CY2020

 

Enrollment in
Health Insurance
(Learn More)

 Private Commercial

3,780,185 in Sept. 2023 
(-0.3% Sept. 2022 
to Sept. 2023) 
3,792,662 in Sept. 2022 
(-2.8% Sept. 2021 
to Sept. 2022

3,902,002 in Sept. 2021 
(-1.1% Sept. 2020 
to Sept. 2021) 
MassHealth (Direct)

1,522,450 in Sept. 2023 
(-0.2% Sept. 2022 
to Sept. 2023) 

1,525,326 in Sept. 2022 
(+7.0% Sept. 2021 
to Sept. 2022) 
1,425,468 in Sept. 2021 
(+10.1% Sept. 2020 
to Sept. 2021)
SCO, One Care, PACE

120,311 in Sept. 2023 
(+8.4% Sept. 2022 
to Sept. 2023) 

110,959 in Sept. 2022 
(+5.8% Sept. 2021 
to Sept. 2022) 

104,870 in Sept 2021 
(+7.9% Sept. 2020
to Sept. 2021) 
Medicare

1,145,176 in Sept. 2023 
(+0.2% Sept. 2022 
to Sept. 2023) 

1,143,373 in Sept. 2022 
(+0.3% Sept. 20218 
to Sept. 2022) 

1,139,829 in Sept. 2021 
(+1.3% Sept. 2020
to Sept 2021)

Percent of Members
Whose Care is Covered
by Alternative
Payment Methods
(Learn More)

 Commercial
41.4
-0.8 pp
from CY2021 to CY2022
42.2%
+0.7 pp
from CY2020 to CY2021
41.5%
+0.6 pp
from CY2019 to CY2020

MassHealth MCOs

87.4%
consistent
from CY2021 to CY2022

87.4%
+0.5 pp
from CY2020 to CY2021

86.9%
+2.4 pp
from CY2019 to CY2020

 

 
 

Massachusetts Provider Utilization and Performance

Measure
Current Data
Antecedent Data
Prior Data
 Fact Sheet

Total Number of
Inpatient Discharges
(Learn More)
749,443 in FY2020
-7.5% from FY2019 to FY2020
810,357 in FY2019
-0.4% from FY2018 to FY2019
813,618 in FY2018
-0.2% from FY2017 to FY2018

Most Frequent Inpatient Discharges by Diagnostic
Related Group (DRG)
(Learn More)

FY20

Normal Neonate Births
(57,875 / -4.5.%)

Vaginal Delivery
(43,941 / -2.0%)

Septicemia & Infections
(36,364 / +2.7%)

Heart Failure
(24,127 / -12.9%)

Cesarean Delivery
(21,388 / +0.5%)

FY19

Normal Neonate Births
(60,625 / -0.2%)

Vaginal Delivery
(44,843 / -1.1%)

Septicemia & Infections
(35,425 / +0.2%)

Heart Failure
(27,700 / +3.0%)

Cesarean Delivery
(21,286 / -2.2%)

FY18

Normal Neonate Births
(60,761 / -0.8%)

Vaginal Delivery
(45,348 / -1.3%)

Septicemia & Infections
(35,371 / +6.0%)

Heart Failure
(26,893 / +4.0%)

Cesarean Delivery
(21,757 / -0.3%)

Statewide Number of
Emergency Department Visits
(Learn More)
2,571,277
in FY2020
3,150,303
in FY2019
3,146,507
in FY2018

Statewide Unplanned
Readmission Rate
(Learn More)
15.9%
in 2020
15.4%
in 2018
15.4%
in 2017

Median Hospital
Total Margin
(Statewide)
(Learn More)
2.6%
in 2020
3.5%
in 2019
 4.5%
in 2018

Relative Price
Statewide Relative Price
(S-RP) Results
(Learn More)

Note: RP values are not
comparable year to year.
CY2019

Range of S-RP Values: 0.717–1.870

Median S-RP: 0.920

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