Post Content

Division of Health Care Finance and Policy Acting Commissioner Seena Perumal Carrington

 

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.

Written By:

Recent Posts

Weekly Flu Report, December 9, 2016 posted on Dec 9

The latest weekly flu report indicates that rates of flu-like illness dropped slightly over the past seven days in Massachusetts. But flu season in New England doesn’t peak until well after the New Year, so there is still plenty of reason to get a flu shot if   …Continue Reading Weekly Flu Report, December 9, 2016

It’s Not Too Late to Get a Flu Vaccine! posted on Dec 5

It’s Not Too Late to Get a Flu Vaccine!

As the busy schedule of the holiday season approaches, now is a great time to get a flu vaccine if you have not gotten vaccinated yet. A flu vaccine can protect you and your loved ones. Everyone 6 months of age and older should get   …Continue Reading It’s Not Too Late to Get a Flu Vaccine!

Weekly Flu Report, December 2, 2016 posted on Dec 2

The latest weekly flu report shows that rates of flu-like illness rose slightly in the past seven days in Massachusetts. Still, it’s safe to say that flu season has yet to really kick in – which means there is still time to protect yourself and your family   …Continue Reading Weekly Flu Report, December 2, 2016