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The Center for Health Information and Analysis (CHIA) today released its latest report on primary care and behavioral health care spending in Massachusetts. Key findings show spending on primary care and behavioral health services continued to vary across major insurance categories between 2022 and 2023.
Primary care and behavioral health encompass an array of services that can meaningfully shape patient outcomes, lead to lower health care costs, and provide more equitable and timely care to Massachusetts residents. This report is part of CHIA’s efforts to offer policymakers and industry leaders objective data that can be used to track system-wide investments as well as to inform policies and market reforms in these areas.
This report focuses on spending for primary care and behavioral health services for members enrolled in private commercial, MassHealth, and Medicare Advantage plans for calendar years (CY) 2022 and 2023. Additional analyses in this report include primary care and behavioral health spending metrics by age group, payer, and managing physician group.
Key Findings:
- In 2023, private commercial plans spent 14.5 percent ($4.0 billion) of total spending on primary care and behavioral health services, a slight decline from 2022.
- MassHealth had the largest increase in primary care per member per month (PMPM) spending, from $31 in 2022 to $48 in 2023, while Medicare Advantage had the highest primary care PMPM spending at $52 in 2023.
- MassHealth had the highest behavioral health PMPM spending at $144 in 2023. Behavioral health spending was $54 PMPM for commercial members and $28 PMPM for Medicare Advantage.
Accompanying this report is a detailed databook, a dataset with payer- and provider-specific primary care and behavioral health spending information, and a technical appendix. Visit the Primary Care and Behavioral Health Care (PCBH) Spending report page on chiamass.gov for more information.
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