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Happy summer! We hope everyone is staying cool in all this heat.
CHIA published several key reports in the past few months, including our first-ever dashboard on health care equity in Massachusetts. This dashboard looks at health care disparities across key measures such as coverage, access, and affordability with findings stratified by race, ethnicity, and geography. Read the “News You Can Use” section below for more detail on CHIA’s health equity work.
CHIA also published the latest editions of the primary care dashboard and behavioral health dashboard, both of which were updated with more recent data and some new measures.
The “Data User Profile” features a frequent user of CHIA data. They explain how they use the MA APCD, along with other data sources, to produce the comprehensive mandated benefit review. See more details below!
Further below in the newsletter, you’ll find a list of upcoming health care-related events that may be of interest.
If you have any questions or opinions you want to share, send your feedback to newsletter@chiamass.gov. We always want to hear from our readers.
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In May, CHIA produced its first dashboard on health care equity to centralize and amplify our equity reporting. This dashboard looks at health care disparities across key measures such as coverage, access, and affordability with findings stratified by race, ethnicity, and geography.
CHIA Executive Director Lauren Peters participated in the third annual Health Equity Trends Summit, highlighting CHIA’s ongoing health care equity work and the new dashboard as part of the keynote panel discussing health equity benchmarks.
CHIA also has several equity-related publications in development. Later this week, we will publish our latest research brief using data from the 2023 Massachusetts Health Insurance Survey (MHIS). This brief explores the correlation between race and ethnicity on unmet health-related social needs. Next month, CHIA will publish its first report examining clinical quality and patient experience measures in primary care through a health equity lens. The report seeks to identify disparities and areas for improvement to ultimately achieve a more equitable health care system. Stay tuned for these upcoming publications!
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Each edition of the DataMatters newsletter includes an interview with a user of CHIA data so they can share their experiences using our data. This month, we are diving into CHIA’s Comprehensive Mandated Benefit Review (MBR) which relies on the MA All-Payer Claims Database (APCD) along with other data sources.
At the request of the Massachusetts Legislature, CHIA regularly evaluates the efficacy and cost impact of health benefit mandate bills. These evaluations are referred to as mandated benefit reviews (MBRs) and can be found on CHIA’s website. The Comprehensive MBR is a report on the cost and public health impact of all existing mandated health insurance benefits, and is required to be completed at least once every four years; the most recent was released in 2021.
Since 2004, CHIA has worked with BerryDunn’s Health Analytics Practice Group to produce these MBRs. We are grateful to Valerie Hamilton, principal at BerryDunn, for answering questions about their experience using CHIA data as well as how the process works to develop the comprehensive MBR.
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Please describe BerryDunn’s role in conducting the comprehensive mandated benefit review and what the review entails.
State law (M.G.L. Chapter 3, §38C) requires CHIA to issue a comprehensive report at least once every 4 years on the cost and public impact of all existing health insurance mandates affecting the fully insured commercial population. The first report under this statute was published in January 2013; however, an earlier comprehensive report was issued under CHIA’s predecessor agency.
BerryDunn, along with its predecessor Compass Health Analytics, has supported CHIA in conducting this study since 2013. The statute grants CHIA authority to gather relevant information from a variety of sources, including insurance carriers. A key component of this work is the analysis of claims data for services required by the mandates under review. The study also incorporates findings from research literature and, when available, relevant information from other states. The in-progress review will be the fourth comprehensive study under §38C.
Which CHIA data did you use to conduct the review?
Prior to 2021, the cost analysis of benefit mandates used an approach that involved comparing self-insured claims to fully insured claims. However, following the Supreme Court’s decision in Gobeille v. Liberty Mutual Insurance Company, which held that under the Employee Retirement Income Security Act (ERISA), states cannot require self-funded employee health plans to submit claims data to all-payer claims databases, self-insured claims data became unavailable. In response, BerryDunn and CHIA adopted a more tailored approach in 2021—developing individual models for each active mandate to support the analysis.
BerryDunn used several data sources from CHIA to support its analysis, including:
- Massachusetts All-Payer Claims Database (MA APCD)—comprehensive claims data from public and private payers
- CHIA Enrollment Data—information on health insurance enrollment in Massachusetts
Depending on the specific benefit mandate, additional CHIA data sources used may include:
- Massachusetts Acute Care Hospital Inpatient Discharge Database (Case Mix)—data on inpatient hospital stays
- Emergency Department Database (Case Mix)—data on visits to emergency departments
- Other public reports produced by CHIA, such as annual reports on coverage, costs, and cost-sharing
Please describe how you use CHIA data to analyze the cost impact of mandated benefits.
Our team uses data from the MA APCD, provided by CHIA, as a foundational resource in evaluating the cost impact of health insurance mandates. We follow a structured, data-driven process to ensure findings are rigorous, well documented, and aligned with CHIA’s standards:
- Develop customized analytical model tailored to the specific mandate under review
- Establish model assumptions using a combination of literature review, clinical expert interviews, and detailed claim-level information from the MA APCD
- Write and refine Statistical Analysis System (SAS) code to extract and prepare relevant data from MA APCD in support of the cost modeling
- Conduct validation and quality checks by comparing outputs with external benchmarks and alternative data sources, as applicable
- Estimate the incremental impact of the mandate on carriers’ medical expenses and on premiums, incorporating assumptions and applying administrative load factors
- Prepare draft and final reports that document methodology, assumptions, limitations, and findings, with iterative review and feedback from CHIA
What other data or research materials do you reference in your work?
In addition to the data sources referenced in Question 2, BerryDunn uses information from the following sources to conduct our analysis:
- Peer-reviewed studies
- Academic journal articles
- Other state legislation, mandated benefit reviews (MBRs), and outcomes data (as appropriate and when available)
- Guidelines from U.S medical societies and the U.S. Preventive Services Task Force (USPSTF)
- Relevant federal and professional sources (e.g., National Institutes of Health and Centers for Disease Control and Prevention [CDC])
- Carrier responses to targeted questions developed for the comprehensive review, along with publicly available carrier information (e.g., medical policies)
- Bulletins from the Massachusetts Department of Insurance and other publicly available state regulatory resources
CHIA and BerryDunn recognize the time and effort that carrier surveys place on carriers and have limited our questions to only those essential to the analysis. BerryDunn incorporates research literature when it is clear, credible, and well-supported (e.g., studies with sufficient sample sizes) and references studies that speak to standards of care or effectiveness without making independent clinical judgments. These multiple sources are used to triangulate findings and inform conclusions for each mandate.
What type of information do you look for as you are analyzing the data?
BerryDunn typically analyzes a variety of data fields when using the MA APCD, including:
- Clinical information: procedure codes, diagnosis codes, and drug codes/names
- Provider details: provider specialty, credential level, and practice location
- Service details: dates of service, units of service, and service type (e.g., medical or pharmacy)
- Member information: unique users of service, age, gender, ZIP code of residence, and coverage type (e.g., self only, family)
- Insurance and payment data: insurance product type, primary coverage indicator, market category (e.g., individual, small group), allowed amounts, plan-paid amounts, and member cost-sharing (e.g., copays, deductibles, coinsurance)
To validate or enhance findings from the MA APCD, BerryDunn may also use data from external sources, including:
- U.S. Census Bureau: demographic and geographic population data
- Medical Expenditure Panel Survey (MEPS): national estimates of health care use and spending
- MassHealth Claims and Eligibility Data: Medicaid-specific insights
- CDC: public health surveillance and disease prevalence data
- State Health Department reports: Massachusetts-specific metrics on health outcomes and service access
| | Publications and Data Releases | | |
Health Care Equity Dashboard
May 2025
CHIA released its first dashboard on health care equity in Massachusetts, which looks at health care disparities across key measures such as coverage, access, and affordability with findings stratified by race, ethnicity, and geography.
Hospital and Hospital Health System Year-To-Date Report
June 2025
CHIA released its latest year-to-date hospital and health system financial performance data, which includes the quarterly period through March 2025. The release includes data from acute hospitals, associated health systems, and physician organizations and provides an update on profitability, liquidity, and solvency for these entities. This publication is presented as an interactive Tableau dashboard and an enhanced databook.
Primary Care Dashboard
June 2025
In collaboration with Massachusetts Health Quality Partners, CHIA has released the latest Primary Care Dashboard to monitor the health of the primary care system in the Commonwealth. New this year, select measures can be stratified by geography, payer type, and sociodemographic dimensions.
Behavioral Health Dashboard
June 2025
CHIA released the latest iteration of its Behavioral Health Dashboard providing a comprehensive overview of the behavioral health landscape in Massachusetts. Measuring and tracking indicators of behavioral health care provide an essential fact base that enables data-driven policymaking and delivery system reforms. The dashboard measures the state of behavioral health care in the Commonwealth across 5 key areas: access, finance, utilization, quality, and equity.
| | Upcoming Events and Resources | | |
This section includes events and announcements of interest to our community, organized by CHIA, other Commonwealth agencies, and others.
CHIA Data User Workgroup
Tuesday, August 26, 2025, 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. For more information, including past presentations and user support materials, visit the data user workgroup information page or the CHIA Data page.
National Academy for State Health Policy (NASHP) Annual Conference
September 8-10, 2025
San Diego, CA
NASHP’s 38th Annual Conference aims to bring attention to the issues facing state health policymakers and highlight possible solutions shared by the nation’s leading experts. Topics will include lowering prescription drug costs, hospital costs, Medicaid, telehealth, social determinants of health, behavioral health, and more. Go to the event page to learn more and to register for the event.
Primary Care Access, Delivery, and Payment Task Force
Wednesday, September 17, 2025, 10 AM – 12 PM
Virtual
The next meeting of the task force can be livestreamed on the Health Policy Commission’s YouTube channel. This task force was charged with studying and making recommendations to improve primary care access, delivery, and payment in the Commonwealth. See the task force website for more information.
CHIA Oversight Council Meeting
Wednesday, September 17, 2025, 2 PM
Virtual
CHIA’s appointed Oversight Council meets quarterly to discuss agency priorities and agenda-setting. The next meeting will stream live on CHIA’s YouTube channel.
Massachusetts Health Policy Commission Board Meeting
Thursday, September 18, 2025, 12 PM
Virtual
The HPC’s 11-member board meets approximately every 6 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 Association of Health Plans (MAHP) Annual Conference
Health Care at a Crossroads—How Federal and State Polices Are Impacting Change
Friday, November 21, 2025, 8 AM – 3 PM
Encore Boston Harbor
Everett, MA
Join the leading voices in health care at MAHP’s 2025 Annual Conference, where more than 500 health care professionals will discuss issues impacting the health care system in Massachusetts and across the country. Visit MAHP conference webpage to view the agenda, register for the event and learn more about available sponsorship opportunities.
| | A selection of open positions at CHIA. Please feel free to share broadly with your network. Follow CHIA on LinkedIn for more regular updates. | | | | |
