CHIA Standard Statistics

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This page was last updated: March 17, 2025.

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

Massachusetts Provider Utilization and Performance

Spending and Insurance Coverage

Measure		Current Data	Antecedent Data	Prior Data

Total Health Care Expenditures (THCE) (Learn More)		$78.1 billion in 2023 $11,153 per capita +8.6% from 2022 (exceeds health care benchmark)	$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

Total Medical Expenses for Commercially-Insured Members (Learn More)		$629 PMPM in 2023 +2.3% from CY 2022 to CY 2023	$615 PMPM in 2022 +3.9% from CY 2021 to CY 2022	$592 PMPM in 2020 +16.1% from CY 2020 to CY 2021

Average Cost of Commercial Coverage (Learn More)	Fully Insured Premiums	$631 PMPM in 2023 +6.0% from CY 2022 to CY 2023	$595 PMPM in 2022 +5.8% from CY 2021 to CY 2022	$563 PMPM in 2021 +6.6% from CY 2020 to CY 2021

Commercial Health Insurance Benefit Levels (Paid-to-Allowed Claims Ratio) (Learn More)	Fully and Self-Insured	0.891 in 2023	0.891 in 2022	0.895 in 2021
	Fully Insured	0.867 in 2023	0.872 in 2022	0.880 in 2021
	Self-Insured	0.905 in 2023	0.905 in 2022	0.908 in 2021

Average Commercial Member Cost-Sharing Level (Learn More)	Fully and Self-Insured	$68 PMPM in 2023 +5.9% from CY 2022 to CY 2023	$61 PMPM in 2022 +6.0% from CY2021 to CY2022	$58 PMPM in 2021 +18.4% from CY2020 to CY2021
	Fully Insured	$84 PMPM in 2023 +10.5% from CY 2022 to CY 2023	$76 PMPM in 2022 +9.7% from CY 2021 to CY 2022	$69 PMPM in 2021 +22.1% from CY 2020 to CY 2021
	Self-Insured	$58 PMPM in 2023 +2.9% from CY 2022 to CY 2023	$52 PMPM in 2022 +2.8% from CY 2021 to CY 2022	$51 PMPM in 2021 +15.7% from CY 2020 to CY 2021

Percent of Members Whose Care is Covered by Alternative Payment Methods (Learn More)	Commercial	40.5% -0.9 pp from CY 2022 to CY 2023	41.4% -0.8 pp from CY 2021 to CY 2022	42.2% +0.7 pp from CY 2020 to CY 2021
	MassHealth MCOs	89.0% +1.6 pp from CY 2022 to CY 2023	87.4% consistent from CY 2021 to CY 2022	87.4% +0.5 pp from CY 2020 to CY 2021

Massachusetts Provider Utilization and Performance

Measure	Current Data	Antecedent Data	Prior Data

Total Number of Inpatient Discharges (Learn More)	749,443 in FY 2020 -7.5% from FY 2019 to FY 2020	810,357 in FY 2019 -0.4% from FY 2018 to FY 2019	813,618 in FY 2018 -0.2% from FY 2017 to FY 2018

Most Frequent Inpatient Discharges by Diagnostic Related Group (DRG) (Learn More)	FY 20 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%)	FY 19 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%)	FY 18 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 FY 2020	3,150,303 in FY 2019	3,146,507 in FY 2018

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	-	-