NEW CASTLE (May 5, 2022) – Department of Health and Social Services (DHSS) Secretary Molly Magarik presented the State’s second annual Benchmark Trend Report at today’s Delaware Health Care Commission (DHCC) meeting. This report displays trends in Delaware’s health care spending and quality, comparing new 2020 data against a set benchmark, as well as baseline data from 2019. This report continues the State’s efforts to improve health care quality for all residents, while simultaneously working to monitor and reduce the economic burden of health care spending.
In November 2018, Governor John Carney signed Executive Order 25, establishing a state health care spending benchmark, an annual per-capita-rate-of-growth benchmark for health care spending, and multiple health care quality measures that are to be evaluated and adjusted every three years.
The first spending benchmark went into effect on Jan. 1, 2019, and was set at 3.8%. That spending benchmark was not met, as the finalized health care spending for 2019 grew at a rate of 5.8%. For calendar year 2020, the spending benchmark was set at a more ambitious target of 3.5%. This benchmark was met as the 2020 Total Health Care Expenditures (THCE) per-capita change from the prior year was estimated at -1.2%. Total expenditures encompass health care spending associated with Delaware residents from private and public sources. Total Health Care Expenditures increased by $39 million in calendar year 2020, totaling $8.1 billion. However, with Delaware’s population increasing by 1.7% from 2019 to 2020, the per-capita total decreased from $8,268 in 2019 to $8,173 in 2020.
“While the decreases in per-capita health care spending and the spending growth rate appear at first glance as a positive change, it is important to note that the COVID-19 pandemic had a significant impact on preventative health care services, health care facility utilization, service delivery, and payer/provider finances,” Secretary Magarik said. “These benchmark findings need to be viewed in the context of the extraordinary circumstances we faced in 2020. And that makes equitable comparisons with previous calendar years extremely difficult.”
“The report continues to showcase the need to lower costs and improve quality in Delaware,” said Steven Costantino, DHSS’ Director of Health Care Reform. “We need to continue to move toward a more value-based care system so that health care is more affordable for all Delawareans. The benchmark has proven to be a useful tool in driving reform and targeting initiatives to improve health care delivery.”
The 2020 Trend Report also provides insight into Delaware’s health care quality by presenting data on six quality measures.
“Unfortunately, the results of the quality measures are mixed,” Secretary Magarik said. “While Delaware made progress in some important measures, the report shows us there is still significant work to be done to improve the health of Delawareans in other areas. At DHSS, we look forward to working with health care providers, insurers, legislators, businesses, other government leaders and, most importantly, consumers to help build a healthier Delaware.”
Overview of Quality Results:
- Adult obesity: The benchmark for 2020 was to reduce the percentage of Delaware adults who are obese to 29.4%. The 2020 result: 36.5%; an increase from 2019 and 7.1 percentage points higher than the benchmark.
- Use of opioids at high dosages: This is a new benchmark for 2020, which used the Delaware Prescription Monitoring Program to observe the rate at which high-dose opioids were prescribed. The 2020 benchmark: 12.4%; the 2020 result: 11.1%. This is a positive observation.
- Opioid-related overdose deaths: The benchmark for 2020 was to reduce the mortality rate to 15.5 deaths per 100,000. The 2020 result: 43.9 deaths per 100,000. This is an increase from 2019.
- Emergency department utilization: The National Committee for Quality Assurance (NCQA) significantly changed the methodology for this quality measure, so it was given first-year status and no calendar year 2020 data was reported.
- Persistence of beta-blocker treatment after a heart attack: The benchmark rate for 2020 was to increase the percentage of patients who receive beta-blocker treatment to 84.9% of commercial insurance patients and to 80.1% for Medicaid patients. The 2020 results: 91.7% for commercial insurance patients and 78.1% for Medicaid patients. While the Medicaid patients did not reach the benchmark, this is a significant improvement from the 2019 results of 73.5%.
- Statin therapy for patients with cardiovascular disease: The benchmark rate for 2020 was to increase the percentage of patients who receive statin therapy to 80.5% of commercial insurance patients and 61.5% for Medicaid patients. The 2020 results: 83.6% for commercial insurance patients; 72.6% for Medicaid patients. For both markets, results were better than the respective benchmark.
To learn more about the health care spending and quality benchmarks, visit the Health Care Commission website.