Annual Report on the Performance of the Massachusetts Health Care System (March 2025)
The Annual Report on the Performance of the Massachusetts Health Care System includes a calculation of Total Health Care Expenditures (THCE) for 2023. THCE is a measure of total statewide health care spending in the Commonwealth.
CHIA examines the performance of the Massachusetts health care system and reports on trends in costs, coverage, and quality indicators to inform policymaking.
In addition to THCE, the Annual Report presents results on health care spending and cost trends, access and affordability, hospital utilization and financial performance, key quality metrics and behavioral health trends. This report primarily focuses on data through 2023; select hospital utilization and financial measures are included through June 2024, where possible.
Key findings from the report were presented at the Health Policy Commission’s (HPC) Health Care Cost Growth Benchmark Hearing on Thursday, March 13, 2025. The annual public hearing solicited testimony, data, and feedback from market participants, stakeholders, and other interested parties to inform the 2026 health care cost growth benchmark. Members of the state Legislature’s Joint Committee on Health Care Financing, led by Senate Chair Cindy Friedman and House Chair John Lawn Jr. co-hosted the hearing alongside the HPC Board of Commissioners.
The hearing was livestreamed on both the HPC's and the Massachusetts Legislature’s websites and the recording is available on the HPC’s YouTube channel.
Key Findings from the Annual Report (Released March 2025)
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- Total Health Care Expenditures (THCE) in Massachusetts totaled $78.1 billion in 2023. From 2022 to 2023, THCE per capita increased 8.6% to $11,153 per resident.
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- Pharmacy spending, along with new MassHealth supplemental payments, drove THCE growth in 2023. Pharmacy spending net of rebates increased by $1.0 billion (10.0%), while MassHealth administered $1.5 billion in new payments to hospitals to support key initiatives in quality and health equity.
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- Between 2021 and 2023, premiums (12.1%) and member cost-sharing (12.9%) outpaced growth in Massachusetts wages and salaries (9.7%).
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- Among employer groups, member cost-sharing was highest for small and mid-size firms ($107 and $86 per member per month, respectively) and increased by more than 10% in 2023, driven by higher enrollment in high-deductible health plans.
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- While affordability was a pervasive issue in Massachusetts with 41.3% of residents overall having issues paying for health care, the burden was greater for Hispanic residents (58.2%) and non-Hispanic Black residents (48.7%).
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- In HFY 2023, the statewide acute hospital median total margin increased by 6.4 percentage points, from -4.2% to 2.2%, while the statewide median operating margin was 0.2% with just over 50% of hospitals (32 of 60 hospitals) reporting a positive operating margin.
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- Acute care utilization has moderated since the COVID-19 pandemic, with inpatient discharges and ED visits increasing but still below pre-pandemic levels, and ALOS decreasing but still above pre-pandemic levels as of June 2024.
Previous CHIA Annual Reports
2024
2023
2022
2021
2019
2018
2017
2016
2015
2014
2013
