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Fall is quickly passing and Thanksgiving is just around the corner as we send out this DataMatters newsletter.

Today, we highlight the recently released quarterly updates using the Case Mix datasets for hospital inpatient discharge data (HIDD), emergency department data (EDD), and outpatient observation data (OOD). See the “News You Can Use” section below for details on the most recent reporting. Earlier this fall, CHIA also published the latest quarterly hospital and health system financial performance report, with data through June 30, 2024.

In the coming months, CHIA will release results from the 2024 Massachusetts Employer Survey as well as its report on Annual Hospital-Wide Adult All-Payer Readmissions for state fiscal years 2011-2023. Stay tuned!

Below you can also read our latest interview with a user of CHIA data in the “Data User Profile” segment, who utilized the MA APCD to explore the application of fluoride during children’s dental visits. You can also catch up on upcoming health care-related events and see details on all recent publications by CHIA.

As always, we welcome your feedback on this newsletter at newsletter@chiamass.gov.

Happy holidays! 

Note: Example of HIDD interactive dashboard above. 

CHIA has just released the latest quarterly updates reporting trends in health care utilization in the Commonwealth, sourced from each of the Case Mix databases: hospital inpatient discharge database (HIDD), emergency department database (EDD), and outpatient observation database (OOD). Quarterly reports contain both final annualized data as well as interim data and are updated as more complete information becomes available.

These dashboards establish an important baseline of hospital utilization that can be used for public health initiatives, analyses of preventable hospitalizations and readmissions, and comparative cost and outcomes research.

The most recent dashboards include data from October 2019 through June 2024.

Key Findings:

• The total number of acute care inpatient discharges has remained relatively stable through the first three quarters of FFY 2024, the first time since the beginning of the COVID-19 pandemic. 

• The average length of stay during an emergency department visit has been steadily decreasing since its peak in Q2 of FFY 2022, from 5.8 hours to 5.0 in the most recent quarter. 



• Over the last three quarters of FFY 2024, the number of observation visits associated with any behavioral health condition have increased by almost 7 percent while the average length of stay for those visits has decreased by almost 17 percent. 

In every DataMatters newsletter, CHIA highlights a recent user of one of our robust datasets. This month, we are featuring a study performed using the Massachusetts All-Payer Claims Database (MA APCD), Clinician Characteristics Associated with Fluoride Varnish Applications During Well-Child Visits. This study explored the factors associated with the likelihood and intensity of applying fluoride varnish overall and for visits paid by private insurers and Medicaid.

We are grateful for Dr. Ashley Kranz, Senior Policy Researcher at the RAND Corporation, and Dr. Kun Li, Postdoctoral Associate at Duke University, for sharing their work with CHIA and answering our questions. 

What was your research question? Why did you choose that question?

Our study examined clinician characteristics associated with the provision of fluoride varnish during well-child visits.

Fluoride varnish is a preventive oral health service that helps to prevent tooth decay. Applying this treatment to young children’s teeth during well-child visits is recommended by clinical guidelines and reimbursed by both Medicaid and private insurers.

However, our team’s prior work found that this treatment was infrequently applied—during only 6.6 percent of visits paid by private insurers and 14.2 percent of visits paid by Medicaid during 2016-2018 in Massachusetts. This motivated us to explore characteristics associated with primary care clinicians’ (PCPs) provision of fluoride varnish.

Which CHIA data did you use?

We used the Massachusetts All-Payer Claims Database (MA APCD Version 8.0). 

What was your experience using CHIA data?

Although analyzing claims data is always challenging, we were excited to use the MA APCD because it allowed us to obtain rich information on clinicians’ service delivery patterns, patient-panel characteristics, and all-payer information—as it is not common to find a dataset in which you can examine visits paid by Medicaid and private insurers.

Please briefly describe your research and a few key findings.

We studied PCPs providing care to children ages 1 to 5 years and identified whether and how often they applied fluoride varnish during well-child visits. First, we found that few PCPs applied fluoride varnish. During 2016 to 2018, only about one in three PCPs applied fluoride varnish in a year. Among those who ever applied this service, they applied it during 27% of their well-child visits.

Second, we found that PCPs with a higher percentage of patients insured by Medicaid and a higher percentage of patients ages 1 to 5 years were more likely to apply fluoride varnish. We observed similar patterns when conducting analysis separately for PCPs’ visits paid by Medicaid and private insurers.

Which findings were particularly interesting, or surprising for you?

We found intriguing that PCPs’ patient-panel characteristics (e.g., share of patients insured by Medicaid and ages 1 to 5 years) were strong predictors of fluoride varnish applications, while their provision of this service did not differ much by PCP age, sex, specialty, and training. 

What “takeaway” information would you like to highlight from your research and/or experience using our data?

Even with clinical recommendations and reimbursement from insurers, few PCPs provided fluoride varnish during well-child visits. Our findings suggest the necessity of future research to understand additional barriers to providing this service and the need for targeted interventions that account for PCPs’ patient-panel characteristics to expand this service in primary care settings.

HIDD, EDD, and OOD Case Mix Quarterly Dashboards

November 2024

The most recent quarterly interactive dashboards on hospital inpatient discharge data (HIDD), emergency department data (EDD), and outpatient observation data (OOD) are now available. These updates show trends revealed by Case Mix data from October 2019 to June 2024. Quarterly reports are based on interim data and are updated as more complete information becomes available.

Quarterly Hospital Financial Performance Report with Data through June 30, 2024

October 2024

Earlier this fall, CHIA released the most recent quarterly acute hospital and health system financial performance report with data through June 30, 2024. Each quarter, CHIA publishes this report on the profitability, liquidity, and solvency of hospital health systems and their affiliated acute hospitals as well as the profitability of affiliated physician organizations.

This section includes events and announcements of interest to our community, organized by CHIA, other Commonwealth agencies, and others.

CHIA Data User Workgroup

Tuesday, November 26, 2024, 3 PM

Virtual

These ongoing meetings are designed for data users and other interested parties to connect with CHIA to discuss analytical techniques and best practices in research using CHIA’s MA APCD and Case Mix databases.

The next virtual workgroup meeting will be Tuesday, Nov. 26, at 3 PM. For more information, including past presentations and user support materials, visit the data user workgroup information page. To learn more about CHIA data, visit https://www.chiamass.gov/chia-data.

MHA’s Annual Women Leaders in Healthcare Conference

Thursday, December 5, 2024, 8 AM – 3 PM

Westin Seaport, Boston, MA, 02110

MHA’s Annual Women Leaders in Healthcare Conference takes place Thursday, Dec. 5, and is titled “Women Supporting Women: Strength in Community Building.” The conference features, among others, Massachusetts Attorney General Andrea Joy Campbell and Harvard University Professor and acclaimed author Sarah Elizabeth Lewis. Among the topics featured in breakout panels are “Women on Boards—Exploring Opportunities, Challenges, and Paths to Success,” “The Triumphs and Trials of Female Executives,” and “How Emotions Are Made: You Have More Control Over Them Than You Think.” See the full agenda or register to attend.

Massachusetts Public Health Association (MPHA) Annual Conference and Meeting

Tuesday, December 10, 2024, 9 AM – 1 PM

Virtual

MPHA’s Annual Conference is an educational event that virtually works to bring together public health advocates from across Massachusetts with the goal of achieving health equity in the Commonwealth. There will be scheduled sessions on policy priorities and how to work across different public health issues. At the end of the conference, MPHA will hold its Annual Business Meeting where new Board Officers and Members will be elected, followed by an afternoon session for students. Check the website for ticket sales.

CHIA Oversight Council Meeting

Wednesday, December 11, 2024, 2 PM

Virtual

CHIA’s appointed Oversight Council meets quarterly to discuss agency priorities and agenda-setting. The next meeting is scheduled for Dec. 11 and will stream live on CHIA’s YouTube channel.

Massachusetts Health Policy Commission Board Meeting

Thursday, December 12, 2024, 12 PM

Virtual

The HPC’s 11-member Board meets approximately every six weeks throughout the year to review the agency’s major workstreams and other topics related to health care cost containment and reform. Major reports, statutory regulations, and publications are authorized by a majority vote at these meetings. Meetings will stream live on HPC’s YouTube channel.

Massachusetts Health & Hospital Association (MHA) Annual Meeting

Thursday, January 30, 2025, 9 AM –7 PM

Westin Seaport Hotel, Boston, MA

Registration is open for MHA's 88th Annual Meeting that will take place on Thursday, January 30, 2025, at the Westin Seaport in Boston. The single-day gathering includes keynotes from local and national speakers as well as expert panels, including one dedicated to the payer perspective, featuring the CEOs of local health plans, and another offering the hospital CEO perspective on the state of the commonwealth’s health care system.

Join Our Team

A selection of open positions at CHIA. Please feel free to share broadly with your network. Follow CHIA on LinkedIn for more regular updates.

Health Care Financial Analyst

Provider Finance Team