Publications

Since 2012, the Patient Protection and Affordable Care Act (ACA) contraceptive mandate has sought to make contraception more affordable and accessible for patients. The mandate requires commercial insurers to cover at least one form of contraception in each Federal Drug Administration (FDA)-approved category of contraception without patient cost-sharing, as well as related services.

Part two of this DataPoints focuses on shifts in site of care delivery in recent years and on spending and out-of-pocket spending by site of care, comparing urgent care centers, retail clinics, physician offices, hospital outpatient departments (HOPDs), and emergency departments (EDs).

Part one of this DataPoints focuses on the recent landscape of these alternative care sites, including trends in the number of sites; location by region and community income; and services, hours, and electronic health record systems used.

A key aspect of the affordability challenge in Massachusetts is rising out-of-pocket (OOP) costs. The HPC has found that average OOP spending among commercially-insured residents increased by 20% from 2015-2017, with an estimated 100,000 Massachusetts residents facing persistently high OOP spending.

The Executive Office of Health and Human Services (EOHHS), in collaboration with the Massachusetts Health Policy Commission (HPC) and the Center for Health Information Analysis (CHIA), convened the Quality Measure Alignment Taskforce (“Taskforce”) in 2017.

Access to high quality and affordable oral health care continues to be a challenge for many Massachusetts residents, in part due to inadequate insurance coverage, affordability of out-of-pocket costs, and a shortage of dental professionals caring for Medicaid patients.

The Massachusetts Health Policy Commission (HPC) estimated that nearly 40 cents of every additional dollar earned by Massachusetts families between 2016 and 2018 was spent on health care and that 23% of middle class families in Massachusetts with employer coverage devoted more than a quarter of all earnings to health care.

This DataPoints issue provides key facts about the 14 ACOs that were recertified by the HPC in December 2019 (“certified ACOs”), with a focus on their risk contracts, approaches to provider compensation, and delivery system improvement efforts.

In this issue of DataPoints, the HPC uses data from the MA-RPO program, a first-in-the-nation statutory reporting requirement designed to collect public, standardized information on the structures and relationships of large Massachusetts providers, to examine physician affiliations and changes in the physician market.

In this issue of DataPoints, the HPC analyzed commercial claims for telehealth services from 2015 to 2017 (the most recent data available at time of publication) to characterize the extent and growth of telehealth usage among Massachusetts residents.