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Annual Report on the Performance of the Massachusetts Health Care System (March 2026)

Annual Report

CHIA examines the performance of the Massachusetts health care system and reports on trends in costs, coverage, and quality indicators to inform policymaking. 

The latest Annual Report on the Performance of the Massachusetts Health Care System includes a calculation of Total Health Care Expenditures (THCE) for 2024. THCE is a measure of total statewide health care spending in the Commonwealth.

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 2024; select hospital utilization and financial measures are included through June 2025, where possible.

Key findings from the Annual Report will be presented at the Health Policy Commission’s Health Care Cost Growth Benchmark Hearing scheduled for 12 p.m. Wednesday, April 1, 2026. This annual public hearing solicits testimony, data, and feedback from market participants, stakeholders, and other interested parties to inform the 2027 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., will co-host the hearing alongside the HPC Board of Commissioners. The hearing will be livestreamed by the HPC, and the recording will be posted to the HPC’s YouTube channel following the hearing.

Key Findings

    • From 2023 to 2024, THCE per capita increased 5.7% to $11,663, the fourth year in a row the state has exceeded the 3.6% health care cost growth benchmark.
      (see page 20)

    • Pharmacy and hospital outpatient spending drove THCE growth in 2024, increasing $1.5 billion and $1.1 billion, respectively.
      (see page 29)

    • Premiums for residents with fully insured employer-sponsored insurance rose nearly 5% in 2024, to $683 per member per month (PMPM). Small and mid-size employers had the highest premiums at $685 and $697 PMPM, respectively.
      (see page 50)

    • Member cost-sharing was also highest for employees at small and mid-size organizations ($117 and $92 PMPM, respectively); across small, mid-size, large, and jumbo group employers, cost-sharing rose 7% to 10% in 2024.
      (see page 52)

    • Disrupting a decade-long growth trend, enrollment in high-deductible health plans decreased in 2024 across all employers except mid-size organizations.
      (see page 55)

Previous CHIA Annual Reports

2025

2024

 

2023

2022

2021

2019

2018

2017

2016

2015

2014

2013