NEW CASTLE (May 7, 2024) – Per capita health care spending in Delaware increased 6.3% in 2022 to $9,657, outpacing a 3% growth rate benchmark, according to the State of Delaware’s fourth annual Benchmark Trend Report presented Thursday May 2 to the Delaware Health Care Commission (DHCC) by Department of Health and Social Services (DHSS) Secretary Josette Manning.

Along with tracking the year-over-year percentage change in total health care expenditures expressed on a per capita basis, the benchmark report also reflects data trends on nine health care quality measures and offers insight on health disparities to guide efforts to improve health equity throughout the State.

Annual trend reports dating back to the initial release in 2019 reflect continued per-capita growth in health care spending beyond established benchmarks. That year, spending grew at a rate of 5.8%, exceeding a 3.8% spending benchmark. While a 3.5% benchmark was met in calendar year 2020, in 2021, reflecting the rebound from the COVID-19 pandemic, health care spending grew at a rate of 11.2% compared to a benchmark of 3.25%.

The 6.3% per capita increase in 2022 is significant, but there was an expectation of some continuing health care spending rebound effect in the post-pandemic period. Moving forward into 2023 and beyond, DHSS expects Delaware’s health care market to be in a steadier state.

“We recognize the economic burden of the rising costs of health care and the benchmark continues to be a valuable tool for the State to compare health care spending year over year, and drive targeted initiatives to improve health care delivery,” Secretary Manning said. “This report shows us there is still significant work to be done to improve the health outcomes of Delawareans.”

Quality benchmark results

The 2022 Trend Report also provides insight into Delaware’s health care quality on nine quality measures with data able to be analyzed by age, gender, and race/ethnicity for greater insight on health disparities. While the most recent report does show some improvement in use of opioids at high dosages, as well as the use of statin therapy for patients with cardiovascular disease, and both breast and colorectal cancer screenings for patients with commercial coverage, opportunities to meet benchmark continue to exist in most areas. Of note given recent reports of a concerning spike in drug overdoses in Sussex and Kent counties, the quality measures underscore urgency regarding Substance Use Disorder/Opioid Use Disorder Outcomes in Delaware.

Three of the measures – Breast Cancer, Cervical and Colorectal Cancer Screening – are new to the 2022 cycle of quality benchmarking.

Overview of Quality Results:

• Adult obesity: The benchmark for 2022 was to reduce the percentage of Delaware adults who are obese to 31.9%. The 2022 result: 37.9%; an increase from 2021, and still 6.0 percentage points higher than the benchmark.
• Use of opioids at high dosages: The 2022 benchmark: 10.8%; the 2022 result: 10.4%. This is a positive observation.
• Opioid-related overdose deaths: The benchmark for 2022 was to reduce the mortality rate to 38.0 deaths per 100,000. The 2022 result: 50.2 deaths per 100,000. This is an increase from 2021 and is well-above the benchmark.
• Emergency department utilization: The benchmark for 2022 was to reduce Emergency department utilization to 160.7 visits per 1,000. The 2022 result: 168.4 visits per 1,000. The 2022 result is worse than 2021 and is higher (worse) than the benchmark.
• Persistence of beta-blocker treatment after a heart attack: The benchmark rate for 2022 was to increase the percentage of patients who receive beta-blocker treatment to 86.8% of commercial insurance patients and to 83.0% for Medicaid patients. The 2022 results: 76.5% for commercial insurance patients and 80.6% for Medicaid patients. Neither the commercial nor Medicaid results met the benchmark; however, Medicaid results remain consistent between 2021 and 2022.
• Statin therapy for patients with cardiovascular disease: The benchmark rate for 2022 was to increase the percentage of patients who receive statin therapy to 83.1% of commercial insurance patients and 73.1% for Medicaid patients. The 2022 results: 82.0% for commercial insurance patients; 64.5% for Medicaid patients. Neither market met the benchmark, but there was improvement in the commercial results from 2021.
• Breast Cancer Screening: The new benchmark rate for 2022 was to increase the percentage of patients who receive breast cancer screening to 75.7% of commercial patients and 57.9% for Medicaid patients. The 2022 results: 77.0% for commercial insurance patients; 53.8% for Medicaid patients. The commercial results exceeded the 2022 benchmark.
• Cervical Cancer Screening: The new benchmark rate for 2022 was to increase the percentage of patients who receive cervical cancer screening to 76.2% of commercial patients and 55.1% for Medicaid patients. The 2022 results: 74.1% for commercial insurance patients; 52.6% for Medicaid patients. Neither market met the benchmark in the first year of reporting.
• Colorectal Cancer Screening: The new benchmark rate for 2022 was to increase the percentage of patients who receive cervical cancer screening to 61.0% of commercial patients. The 2022 results: 62.3% for commercial insurance patients. This is a positive observation.

The 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—was established through Executive Order 25 signed by Governor John Carney in November 2018 and codified in August of 2023 through House Amendment 1 for House Bill 442.

To learn more about the health care spending and quality benchmarks, visit the Health Care Commission website.

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