This week, the Division prepared for an important event – the first filing of total medical expense data as required by Chapter 288. Of all the new data our 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.
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. We would like to thank payers for their assistance as we become the first state in the nation to collect this data.
Similarly, we 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 to receiving our inaugural TME filings today and sharing our analysis with the public in the months to come.
Some Workers Face Higher Risk of Injury – But Employers Can Make a Difference posted on Jul 25
In the six years from 2008 through 2013, 356 workers died on the job in Massachusetts. This is about one worker every five days! The MDPH CFOI and MA FACE projects developed this infographic to illustrate these tragic worker deaths and to underscore the human costs …Continue Reading Some Workers Face Higher Risk of Injury – But Employers Can Make a Difference
Making Your Summer POP! posted on Jul 19
Few things are better than an ice-cold popsicle on a hot summer day! I have vivid memories from my childhood running around through the sprinkler and various neighbors’ yards enjoying the summer sun. At that age, having a messy red ring around your mouth from …Continue Reading Making Your Summer POP!
Massachusetts is Rewarding Small Businesses for Healthy Workplaces posted on Jul 18
Wellness programs are good for business. They can lead to better performing workers, lower absenteeism and decreased healthcare and insurance costs. Now, small businesses can be rewarded for these efforts! The Massachusetts Wellness Tax Credit Incentive gives small businesses in Massachusetts a state tax credit …Continue Reading Massachusetts is Rewarding Small Businesses for Healthy Workplaces