Ten Miles Square


April 12, 2012 11:41 AM Massachusetts’s High Health Care Burden

By Austin Frakt

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 New England Journal of Medicine 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 Accountable Care Organization (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 statehealthfacts.org 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.

[Cross-posted at The Incidental Economist]

Austin Frakt is a health economist and an assistant professor at Boston University's School of Medicine and School of Public Health. He blogs at The Incidental Economist.


  • ninjanurse on April 12, 2012 8:10 PM:

    Some thoughts from a nurse-
    It seems a no-brainer that access to health care for everyone is the best way to solve many social problems, not to mention protect us from the next security threat Mother Nature is cooking up. She can be a bitch when she favors microbial life.
    However, health insurance does not equal health care, and lots of time in doctor's offices doesn't equal health.
    I do think that providing primary, preventive and emergency care to everyone will pay off in the near future, but will require a big investment up front.
    The good news is that if health dollars are used wisely, they generate employment. Health care is very labor-intensive, so the money does stay in the state.