Massachusetts' per capita healthcare spending was 36 percent higher than the national average in 2009, and spending on hospital and long-term care accounted for the bulk of that difference, according to a new report from the state.
The Massachusetts Health Policy Commission released its Preliminary Cost Trends Findings report, finding "spending in Massachusetts is the highest of any state in the U.S., crowding out other priorities for consumers, business and government." The report examines data from 2001 through 2009. Massachusetts passed its own healthcare reform law in 2006 and a cost control law in 2012. The commission was established as part of that law to monitor the sector's cost growth.
According to the report, Massachusetts' per capita personal healthcare expenditures for hospital care make up about 42 percent of the $2,463 per capita difference in personal healthcare expenditures between the national average and Massachusetts. (The average is $6,815 nationally, $9,278 for Massachusetts.) Long-term care and home health accounts for 31 percent of the difference.
The state's unique delivery system and the use of major teaching hospitals for more inpatient care is a major driver of the spending difference. Forty percent of Medicare discharges in Massachusetts occur in major teaching hospitals, for instance, compared to 16 percent nationwide.
There is higher hospital utilization throughout the state as a whole compared to nationwide. Hospital inpatient admissions in the state are 10 percent higher and hospital outpatient visits — excluding emergency department care — are 72 percent higher than the national average.
Further, commercial hospital inpatient prices are up 10 percent in the state compared to the national average. Medicare prices are 8 percent higher in Massachusetts, largely driven by wage and teaching adjustments. Medicaid unit prices for physician services are 30 percent higher.
The report does not measure cost escalation against the 3.6 percent growth benchmark established in Massachusetts' 2012 cost control law. That benchmark will be reviewed in 2014 and a report next year will measure progress against the benchmark, according to a WBUR report.
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