Publications

While Massachusetts has achieved a high rate of insurance coverage among its residents, access and affordability issues continue to persist across all groups regardless of age, sex, race, ethnicity, health status, or family income. The MHIS results provide a detailed look at the issues facing Massachusetts residents.

In the 2025 survey, new questions were included on behavioral health care, tax-advantaged health spending accounts (such as HSAs and FSAs), and administrative burden impacting access to care. The survey was fielded from January to April 2025 and was funded in part by a grant from the Blue Cross Blue Shield of Massachusetts Foundation.

This research brief explores family medical debt in Massachusetts. Findings show that cost-sharing—especially deductibles—is the most common source of medical debt in the Commonwealth.

Despite near-universal health insurance coverage, more than 1 in 8 Massachusetts residents carries family medical debt. Medical debt poses a persistent affordability challenge and is associated with a wide range of negative consequences, from forgoing medical care to facing food insecurity and housing instability.

CHIA has published a comprehensive review of state-mandated health insurance benefits and health insurance costs in Massachusetts. This report includes a review of the 59 mandated benefits Since the last published report, 18 new mandates have been enacted, 16 of which are included in this report.

CHIA evaluates the impact of health benefit mandate bills referred by Massachusetts legislative committees. These evaluations provide a medical efficacy analysis and an estimate of the effect on health insurance costs. CHIA performs a comprehensive retrospective review, typically every four years, of all mandates in effect.

CHIA's Acute Hospital and Health System Annual Financial Performance Report provides information on the profitability of hospital health systems, their affiliated acute hospitals and physician organizations, as well as the profitability of non-acute hospitals. 

CHIA monitors and provides meaningful analysis on Massachusetts hospitals and hospital health systems through a variety of metrics and studies. See the financial metrics formulas and calculations used for hospital and health system financial reporting.

Enrollment Trends monitors health insurance coverage in Massachusetts, where coverage is defined by unique Massachusetts residents in primary, medical membership within the top 12 commercial payers, MassHealth (Medicaid), and Medicare.

Medicare Advantage counts exclude enrollment in Senior Care Options (SCO), One Care, and Program of All-inclusive Care for the Elderly (PACE) plans, which are reported separately. Individuals who are dually eligible for MassHealth and Medicare are classified under “Medicare” unless they are enrolled in SCO, One Care or PACE plans.