The Center for Health Information and Analysis (CHIA) released its Annual Report on the Performance of the Massachusetts Health Care System. The report documented a 9% growth rate in total health care expenditures in 2021, which is well above the state’s established 2021 cost growth benchmark of 3.1%. The report looks at spending in the following service categories: hospital inpatient, hospital outpatient, pharmacy, physicians and other medical spending which includes skilled nursing facilities and home health services, with pharmacy (net of prescription drug rebates) experiencing the greatest growth in spending at 7.5%. Relative to nursing home care, CHIA reported that the sector experienced a negative 0.9% median operating margin in 2021 with an overall occupancy of 75.1%.