SUMMARY: Massachusetts continues to see skyrocketing health-care costs. Why you should care:  Romneycare, an Obamacare lookalike, has been in effect for long enough to see results. Those results included expanded access to care — the state has the highest rate of insurance coverage in the nation — but costs did not go down. The reasons? Not exactly what you’d expect.



Our friend David Harlow from blogged about this over at Healthworks Collective, citing a new Health Policy Commission report. Here’s his summary: the entire post is here.

A few headlines: don’t be so quick to blame Romneycare. Massachusetts delivers a lot of care in expensive settings, teaching hospitals. That’s more expensive. Also utilization is higher, presumably because more people have access to care.

Also, Massachusetts has generally higher fee schedules than do other parts of the country. That can’t be blamed on Romneycare.

  • Massachusetts is No. 1 in the country for personal health care expenditures:
    • Massachusetts: $9,278 per person
    • U.S.: $6,815
    • If you adjust the data for our older population, broad access to care, and higher overhead costs (wages, rent, supplies, etc.) the difference is still 20%….
  • For private health insurance patients:
    • Hospital spending is 42% higher than the U.S. average
    • Long term care spending is 31% higher
    • Professional services spending is 24% higher (physician, clinical, dental and other services)…
  • Hospital utilization
    • Inpatient admissions: 10% higher
    • Average length of stay: 7% lower
  • Outpatient  utilization
    • Patient visits, excluding emergencies: 72% higher
    • Outpatient surgeries: 27% higher
  • Why are prices higher? Higher fee schedules, and more care is delivered in higher-priced settings
    • Fees paid by commercial payers, Medicare and Medicaid are higher than the national average
    • Portion of Mass. discharges from major teaching hospitals: 41% 
    • Portion of U.S. discharges from major teaching hospitals: 16%

Check out the rest of the HPC report highlights. A more detailed report will be forthcoming in the new year.

Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...