Happy New Year! We hope you enjoyed the holiday season and have had a fruitful start to 2025.
CHIA has been busy in the past two months. The Massachusetts All-Payer Claims Database (MA APCD) now includes CY 2023 data and is available for public application. CHIA released several reports, including updating the results of the Massachusetts Health Care and Human Services Workforce Survey (MHCW) to include human services data; publishing the latest annual readmissions report for SFY 2011-2023; and releasing results from the 2024 Massachusetts Employer Survey (MES).
Staff are working hard to pull together the next report on primary care and behavioral health spending, to be released later this spring, as well as the Annual Report on the Performance of the Massachusetts Health Care System, set to publish in March.
Below we feature an interview with the team responsible for the annual readmissions report in the “Data User Profile” and their use of Case Mix data, and we highlight recently passed health care legislation with new directives for CHIA in the “News You Can Use” segment.
As you read this newsletter, please send your feedback or any questions you have to newsletter@chiamass.gov.
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CHIA was excited to see the new health care legislation that was signed into law earlier this month. As our readers may know, the bills seek to improve oversight of the health care market and address rising prescription drug costs.
CHIA has new roles and responsibilities in both pieces of legislation. An Act Enhancing the Market Review Process requires hospitals to disclose to CHIA the audited financial statements of the out-of-state operations of a hospital’s parent organization and of significant equity investors, health care real estate investment trusts and management services organizations. The legislation also increases the registered provider organizations (RPO) reporting threshold to include revenue generated from all payers, not just commercial revenue, allowing CHIA and the HPC to collect data from providers that serve significant public payer patients. Lastly, the bill expands CHIA’s authority to monitor the financial conditions of acute hospitals and increases the financial penalties for non-compliance with CHIA reporting requirements.
An Act Relative to Pharmaceutical Access, Costs, and Transparency authorizes CHIA to collect data from pharmacy benefit managers (PBMs) related to drug costs, including information on discounts, utilization limits, rebates, and administrative fees charged to pharmaceutical manufacturing companies. The legislation also directs CHIA to include high-level pharmaceutical cost and price trend information in its Annual Report on the Performance of the Massachusetts Health Care System. Lastly, the new law caps out-of-pocket costs for drugs identified to treat asthma, diabetes, and prevalent heart conditions and directs the HPC, in consultation with CHIA and other state agencies, to evaluate the new program every two years.
CHIA is looking forward to working with its sister agencies, industry partners, and policymakers to implement this legislation.
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Every DataMatters newsletter features a segment highlighting a user of CHIA data. For this issue, we asked an internal user of our data, CHIA’s Strategy and Research team, to provide a detailed look at how they developed the Hospital-Wide Adult All-Payer Readmissions in Massachusetts: SFY 2011-2023 report, which was published in December.
As discussed below, the readmissions report heavily relies on CHIA’s Case Mix datasets to produce its findings. We are grateful to the CHIA staff who participated in the interview for taking the time to answer our questions!
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Please briefly describe the Hospital-Wide Adult All-Payer Readmissions in Massachusetts: SFY 2011-2023 report and analyses.
A hospital readmission is defined as an admission to a hospital within 30 days of a prior hospital stay. While there are some situations in which a second hospitalization within that time frame is part of a predetermined plan of care, the vast majority of readmissions are unplanned. Unplanned hospital readmissions can be used as an indicator of health system performance and have been a key measure of health system quality and value since the Affordable Care Act’s passage in 2010.
In SFY 2023, the adult all-payer, unplanned statewide readmission rate was 16.0 percent, remaining consistent over the past couple of years. This report includes readmission rates by acute care hospitals; patient demographics such as age, sex, and race/ethnicity; and discharge characteristics such as discharge setting and common diagnoses.
What CHIA data do you use for your readmissions reporting?
The primary data source for the readmissions reporting was the Hospital Inpatient Discharge Database (HIDD). This report looks at returns to the inpatient setting following an initial inpatient visit.
The Emergency Department Database (EDD) and Outpatient Observation Database (OOD) were used as supplemental data sources to enhance the reporting of demographic data such as race and ethnicity. Additionally, we used enrollment data from the Massachusetts All-Payer Claims Database (MA APCD) and Medicare’s ResDAC beneficiary data to produce an enhanced insurance payer category for each patient to provide additional insights about the impact of payer type coverage on readmissions. Data linkage across databases was made possible by a unique patient identifier called the MEID provided to us by CHIA’s Data Operations and Technology team. While the HIDD was the primary data source, many of CHIA’s data assets were used for this one report.
What do you look for when analyzing this data? What are some of the key metrics you use?
We report on readmissions rate by hospital, patient demographic factors (like age, sex, and race/ethnicity), and payer type. One of the key metrics used in this report is 30-day readmission to an acute care hospital following an initial discharge. This was calculated by identifying visits for the same patient that had an admission date 30 days or less than an initial discharge date, which we call the index discharge. This measure excludes certain categories of hospitalizations, such as pediatric, obstetric, and psychiatric admissions from the analysis. Visits that are deemed “planned” admissions can be the initial discharge but not the readmission. Planned admissions include visits such as hip and knee replacements so that hospitals are not penalized for visits that otherwise were most likely scheduled ahead of time.
How do you envision stakeholders using the readmissions report?
This report provides valuable insight into the characteristics of the adult readmission population across the Commonwealth. Readmission rates serve as a critical measure for identifying factors that are associated with increased risk of readmission, including common diagnoses, and act as a key performance indicator for acute care hospitals. This report also examines potential disparities in readmission rates between different population subgroups.
These findings will support hospitals partners—including Massachusetts Health and Hospital Association, health plans, and sister agencies such as MassHealth and the Health Policy Commission—in their continued efforts to increase quality and reduce costs associated with unplanned readmissions.
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Publications and Data Releases | |
2024 Massachusetts Employer Survey Results
December 2024
In early December, CHIA published the summary results from a statewide health benefits survey of Massachusetts employers. The Massachusetts Employer Survey (MES) is a biennial survey that asks a representative sample of employers to share their experiences and challenges in offering health insurance and related benefits to their employees.
The 2024 MES provides valuable insights into the employer health insurance market, including how the landscape of workplace health benefits has shifted in the wake of the COVID-19 pandemic and persistent cost pressures.
Annual Readmissions Report
December 2024
As discussed in the Data User Profile above, CHIA published its most recent report on Hospital-Wide Adult All-Payer Readmissions in Massachusetts: SFY 2011-2023 in December. Unplanned hospital readmissions can be used as an indicator of health system performance, for instance as a reflection of appropriate levels of treatment before discharge and follow-up care afterward.
This report is the ninth in CHIA’s annual series of all-payer readmission reports and includes data through SFY 2023 (July 1, 2022, through June 30, 2023). For the first time, this report includes an enhanced payer type classification that leverages insurance enrollment data from Medicare, Medicaid (MassHealth), and commercial payers and includes a new breakout for patients dually eligible for both Medicare and Medicaid.
Health Care Workforce Survey-Human Services Results
December 2024
At the end of December, CHIA updated its Massachusetts Health Care and Human Services Workforce Survey (MHCW) Dashboard to include human services data. See the survey results in an interactive Tableau dashboard.
CY 2023 MA APCD Release
December 2024
CHIA announced that the calendar year (CY) 2023 All-Payer Claims Database (APCD) is ready for public application. This year’s release includes 2019-2023 data with a six-month run out through June 2024. Data in the MA APCD represents the most comprehensive source of medical claims, pharmacy claims, dental claims, member eligibility data, MassHealth enhanced eligibility data, provider data, product data, and benefit plan data from private and public payers on behalf of Massachusetts members.
Quarterly Hospital Financial Performance Report
December 2024
In December, CHIA released the most recent quarterly acute hospital and health system financial performance report with data through September 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.
HFY 2023 Hospital Profiles Overview
January 2025
Earlier this month, CHIA published its latest comprehensive overview of Massachusetts hospital performance for hospital fiscal year (HFY) 2023. Massachusetts Hospital Profiles provide information on acute and non-acute hospitals based on hospital characteristics, services, payer mix, utilization trends, top discharges, and financial performance over a five-year period through HFY 2023.
The profiles are also accompanied by an interactive dashboard for all acute hospitals and their health systems, allowing users to filter results by individual hospital, hospital type, and hospital health system.
Nursing Facility Performance Dashboard
January 2025
CHIA has published a new interactive dashboard on nursing facilities operating in Massachusetts. This centralized dashboard includes key measures at the industry and facility levels to increase transparency of financial and quality performance. The nursing facility dashboard is intended to assist policymakers and stakeholders with accessing and understanding performance metrics for individual nursing facilities and the industry as a whole.
The interactive dashboard allows users to filter data by additional characteristics, such as geographic region, tax status, management company affiliation, and quality rating, enabling users to customize their experience depending on their interest.
To accompany this dashboard, comprehensive cost reports for skilled nursing facilities and their related real estate agencies and management companies have also been published online.
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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, February 25, 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.
The next virtual workgroup meeting will be Tuesday, Feb. 25, 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.
Massachusetts Health Policy Commission Board Meeting
Thursday, February 27, 2025, 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 Policy Commission Benchmark Hearing
Thursday, March 13, 2025, 12 PM
Massachusetts State House, Gardner Auditorium, Boston, MA, and Virtual
The HPC holds a public hearing to determine whether the health care cost growth benchmark should be modified for calendar year 2026. Under the framework set forth in Chapter 224, from 2023 and beyond, the health care cost growth benchmark will be set equal to potential gross state product (PGSP), or 3.6%, unless the HPC determines that an adjustment to the benchmark is reasonably warranted. In that case, the HPC Board may choose to modify the benchmark to any amount.
The hearing will also be livestreamed on YouTube.
CHIA Oversight Council Meeting
Thursday, March 27, 2025, 2 PM
Virtual
CHIA’s appointed Oversight Council meets quarterly to discuss agency priorities and agenda-setting. The next meeting is scheduled for March 27 and will stream live on CHIA’s YouTube channel.
MHA Children’s Behavioral Health Summit
Tuesday, April 1, 2025, 8:30 AM – 3:30 PM
MCLE Conference Center, Boston, MA
The Massachusetts Health and Hospital Association, along with Boston Children’s Hospital, are reconvening behavioral health experts to discuss and review progress and areas for improvement in pediatric behavioral health care, focusing on innovation and prevention. See the event website for more information.
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A selection of open positions at CHIA. Please feel free to share broadly with your network. Follow CHIA on LinkedIn for more regular updates. | |
CENTER FOR HEALTH INFORMATION AND ANALYSIS
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