Massachusetts’ high health care burden

Zirui Song and Bruce Landon summarize the state of Massachusetts’ health care costs (high) and what state officials are attempting to do about it (a lot). Their short NEJM piece is ungated, so you can read it for yourself. The following two statistics caught me by surprise:

  1. The five organizations in the eastern part of the state that are participating in the Pioneer ACO program account for 75% of Medicare beneficiaries in the Boston area. Is the Medicare population associated with ACOs anywhere near that level in any other city? I doubt it. Boston is the ACO capital.
  2. In 2012, health care will consume a majority (54%) of the state’s budget. Among the states, is that the highest proportion? It believe so. Massachusetts is the health spending king.

How do other states compare to Massachusetts in terms of health spending? Accounting only for Medicaid spending, Massachusetts still has the highest proportion of its state budget devoted to health spending. The chart below, made from data, shows this (click to enlarge). But Massachusetts’ health spending is on more than just Medicaid. It also pays for subsidized health insurance through Commonwealth Care. No other state does that.

Yeah, Massachusetts has a big time health spending problem.

IMPORTANT NOTE: A number of good questions about the data underlying the above graph have been raised in the comments and on Twitter. If someone produces a more credible chart, I will post it. For now, take the above with a pound of salt.


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