Post Content

By DHCFP Acting Commissioner Seena Carrington

Seena_carrington

 

Earlier this month the Division of Health Care Finance and Policy  (DHCFP) marked an important event – the first filing of total medical expense data as required by Chapter 288. Of all the new data the agency is collecting, total medical expenses (TME) may be the most interesting with respect to tracking medical spending and the Commonwealth’s cost containment efforts.

But what is TME?  Roughly speaking, TME represents the total cost of care to health plans for the patient population they cover.  This number includes not only payments for medical claims, but also payments such as pay-for-performance and provider care management.  TME may help to identify providers who are especially good at managing care, as well as geographic areas with unusually high or low spending on health care.  TME may also help indicate which medical services are contributing the most to health care costs; and reveal whether managed care patients have higher or lower overall costs than non-managed patients.  Over time, TME data will allow the Commonwealth to track the success of cost containment efforts and growth rate in medical spending by provider group, geographic region, and statewide.

Since last fall, DHCFP has been working with payers and other stakeholders to develop regulations related to the calculation of TME and to ensure the smooth reporting of this data.  We convened a technical advisory group, elicited feedback regarding our proposed methodology in a consultative session, and received testimony during the public hearing process.  All of this input was invaluable in developing and refining our methodology and data specifications.  I would like to thank payers for their assistance as we become the first state in the nation to collect this data.  

I would like to thank payers for their collaboration in developing regulations for relative prices, which will be yet another tool contributing to health care cost transparency.  We anticipate finalizing these regulations shortly.

We look forward sharing our analysis of TME with residents of the Commonwealth in the months to come.

# # #

Written By:

Recent Posts

DTA Cultural Partnership Goes Beyond Providing Benefits by Providing Experiences posted on May 13

DTA Cultural Partnership Goes Beyond Providing Benefits by Providing Experiences

Did you know anyone in Massachusetts with an EBT card can get reduced or free admission into more than 10 museums across the Commonwealth? The MA Department of Transitional Assistance (DTA) partners with educational and cultural institutions statewide granting access to some of the state’s   …Continue Reading DTA Cultural Partnership Goes Beyond Providing Benefits by Providing Experiences

MCB’s Mitch Sanborn wins Paul McDade “FOCUS” Award for Distinguished Leadership posted on May 11

MCB’s Mitch Sanborn wins Paul McDade “FOCUS” Award for Distinguished Leadership

During my brief time serving as Commissioner of the Massachusetts Commission of the Blind (MCB), I have had the pleasure to present numerous awards to individuals and organizations that have made significant contributions to the blindness community.  Last month, I was asked to make another   …Continue Reading MCB’s Mitch Sanborn wins Paul McDade “FOCUS” Award for Distinguished Leadership

Mental Health Awareness Month – DMH Hosts Events Including 22nd Annual Express Yourself Performance posted on May 9

Mental Health Awareness Month – DMH Hosts Events Including 22nd Annual Express Yourself Performance

In honor of national Mental Health Awareness Month, the Department of Mental Health (DMH) will host and participate in several events that follow the national theme: Life with a Mental Illness. According to the National Alliance on Mental Illness (NAMI), one in five Americans will   …Continue Reading Mental Health Awareness Month – DMH Hosts Events Including 22nd Annual Express Yourself Performance