Latest Step in Effort to Reduce Cost, Improve Quality of Care in Delaware

DOVER (April 1, 2021) – Department of Health and Social Services (DHSS) Secretary Molly Magarik presented the state’s first Benchmark Trend Report at today’s Delaware Health Care Commission (DHCC) meeting, summarizing health care spending and quality data collected for calendar year 2019. The report is the latest step in the state’s effort to reduce health care spending and improve quality of care for Delawareans.

The Benchmark Trend Report details total health care spending for 2019 and compares it to baseline data collected for 2018. In late 2018, Governor John Carney signed Executive Order 25, establishing a state health care spending benchmark, a per-annum rate-of-growth benchmark for health care spending, and several health care quality measures. The first spending benchmark went into effect on Jan. 1, 2019, and was set at 3.8%, with the target expected to decrease gradually to 3% over the following three years.

For calendar year 2019, the report found overall health care spending in Delaware totaled $8.2 billion vs. $7.6 billion for 2018. The per-capita cost increased from $7,814 in 2018 to $8,424 in 2019, or 7.8% – more than twice as high as the 3.8% target. Spending in 2019 increased across all spending categories, including the five largest:

• Hospital inpatient: $1.8 billion (up from $1.6 billion in 2018)
• Hospital outpatient: $1.6 billion (up from $1.4 billion in 2018)
• Physician: $1.3 billion (up from $1.2 billion in 2018)
• Pharmacy: $1.2 billion (up from $1.1 billion in 2018)
• Long-term care: $1.1 billion (up from $1 billion in 2018)

“This kind of transparency and public awareness of health care spending is important for everyone in the system – health care providers, consumers, taxpayers, insurers and businesses,” said Secretary Magarik, a member of the Health Care Commission. “The next step is to work with health care providers, insurers, government agencies and consumers to transform the delivery of health care away from volume-based case to value-based care to be consistent with the overall economic growth of the state.”

The report also provided results on six health care quality measures; Delaware improved on two measures, split on one measure, and worsened on three others:

Improved

Adult tobacco use: The benchmark rate for 2019 was to reduce the percentage of Delaware adults who smoke to 17.1%. The 2019 result: 15.9%. Statin therapy for patients with cardiovascular disease: The benchmark rate for 2019 was to increase the percentage of commercial insurance patients who receive statin therapy to 79.9% and for Medicaid patients to 59.2%. The 2019 results: 85.3% for commercial insurance patients; 65.1% for Medicaid patients.

Split

Persistence of beta-blocker treatment after a heart attack: The benchmark rate for 2019 was to increase the percentage of commercial insurance patients who receive beta-blocker treatment to 82.5% and to 78.8% for Medicaid patients. The 2019 results: 93.9% for commercial insurance patients, but 73.5% for Medicaid patients.

Worsened

Adult obesity: The benchmark for 2019 was to reduce the percentage of Delaware adults who are obese to 30%. The 2019 result: 34.4%. Opioid-related overdose deaths: The benchmark for 2019 was to reduce the mortality rate to 16.2 deaths per 100,000. The 2019 result: 43 deaths per 100,000. Emergency department utilization: The benchmark for 2019 was to reduce the rate to 190 visits per 1,000. The 2019 result: 193.2 visits per 1,000.

“While we made progress as a state in reducing adult tobacco use and increasing the use of statins for patients with heart disease, we have much more work to do reduce the adult obesity rate, deaths from opioid overdoses and emergency department utilization,” Secretary Magarik said. “Working together, I know we can make more progress in improving the overall health of Delawareans.”

The Delaware Health Care Commission previously collected spending data from calendar year 2018 to provide a preliminary basis for calculating the state’s health care spending performance and to serve as a baseline for the 2019 spending growth calculations. The 2018 baseline data collection also allowed the state’s health insurers and the DHCC to test payers’ data-submission methods and identify areas for improvement.

The release of the 2019 spending and quality data is another step along the state’s “Road to Value” initiative to improve access to affordable, quality health care for all Delawareans. That effort remains critically important even as Delaware responds to the COVID-19 crisis, Secretary Magarik said.

“As our state continues to respond to the global pandemic, we will need to support the health care system with value-based goals, knowing that too many Delawareans have put off their health care needs,” Secretary Magarik said. “The Benchmark Trend Report will help us to focus those goals.”

The Heath Care Commission is accepting written public comments on the Benchmark Trend Report through Friday, April 9, at: DHCC@delaware.gov. To learn more about Delaware’s health care spending and quality benchmarks, visit the Delaware Health Care Commission website.