“Today’s CHIA report on the performance of the Massachusetts healthcare system finds that statewide healthcare spending growth came in below the benchmark. It also indicates that for the third year in a row, hospital commercial inpatient spending growth continued to be well below the cost growth benchmark. On the outpatient side, in contrast to previous years, the rate was higher. While this trend merits additional attention, the report does not provide further insight into what could be driving the increased outpatient spending. 

It is likely that a number of factors are propelling this change, including the transition of increasingly complex surgery from inpatient to outpatient settings, more encouragement for patients to have diagnostic/preventive screenings such as mammograms and colonoscopies, higher costs for pharmaceuticals that are administered in outpatient settings, and growing use of observation services, which are considered outpatient care while physicians determine whether a patient needs to be admitted. Hospitals have been investing heavily in outpatient care and ambulatory care facilities to be able to provide care in the most appropriate setting, in line with state and federal policy directives.  It’s possible that CHIA’s most recent report is reflecting this investment.

If the increase stems from transitions of care from higher cost settings to lower cost settings, it may indeed be a logical trend, but needs to be better understood.”