NEW CASTLE – Per capita healthcare spending in Delaware increased 9.1% in Calendar Year (CY) 2023, outpacing the spending benchmark set at a 3.1 percent growth rate for the CY 2023 performance period. The State of Delaware’s fifth annual Health Care Benchmark Trend Report was presented today by the Department of Health and Social Services (DHSS) to members of the Delaware Health Care Commission, the public/private policy-setting body created to develop a pathway to basic, affordable healthcare for all Delawareans.

The spending benchmark is the target value annual percentage change in the State-level per capita value of Total Health Care Expenditures (THCE) for all Delaware residents based on data submitted by Delaware payers. Delaware is one of eight states, including neighboring New Jersey and Maryland, to establish statewide health care cost growth targets, ranging from 3.0 to 3.4%.

Delaware’s THCE was approximately $10.9 billion for the CY 2023 performance period, The per capita amount was $10,588, which represents a 9.1 percent year-over-year increase from CY 2022. During this same period, Delaware’s population increased 1.3%.

There have been significant inflationary increases on health care costs and services, driving larger-than-expected increases nationally, as well as locally within the State. While Medicare is the largest bucket for THCE, at about one-third of State health care spending, all markets showed an increase in per capita spending, most significantly in Medicaid and the Veterans Health Administration markets.

Total Medical Expenditures (TME) totaled $9.9 B in CY 2023, an increase of approximately 10.4% from CY 2022. Hospital Inpatient (Not Pharmacy) and Prescription Drug Benefits (Net of Rebates) were the largest TME service categories, each at $2.0B, followed by Hospital Outpatient at $1.7B, Physician at $1.4B, and Long-Term Care at $1.3B.

“The benchmark trend report is an important tool for raising awareness and spurring dialogue regarding the level and type of health care spending occurring in Delaware,” said DHSS Cabinet Secretary Josette Manning. “A billion dollar increase in total health care expenditures in just one calendar year is significant, concerning, and unsustainable, especially in a time when states can no longer rely on federal healthcare funding. The Diamond State Hospital Cost Review Board will play a critical role in monitoring hospital expenses as we continue to work to ensure the greatest possible value in both cost and quality of care for the people of Delaware.”

Quality benchmarks

In addition to the spending benchmark, Delaware also tracks several quality measures against an established annual quality benchmark.

Delaware did better than the benchmark in two quality measures in CY 2023:

• Use of Opioids at High Dosage improved by 0.8 percentage points in CY 2023 and was 0.4 percentage points below the benchmark for this measure where lower is better.
• Breast Cancer Screening exceeded the CY 2023 benchmark by 1.0 percent among patients covered by Delaware’s commercial market. However, in this measure where a higher number is better, among patients covered by the Medicaid market, screenings were 2.9 percent below the CY 2023 benchmark.

Results improved in both the adult obesity and opioid-related overdose deaths per 100,000 measures, although neither measure met the CY 2023 benchmark.

• Adult Obesity decreased by 2.3% in CY 2023 and was 4.4 percentage points above the benchmark (lower result is better).
• Opioid-Related Overdose Deaths decreased by 2.7 deaths per 100,000 in CY 2023 but were 14.5 deaths per 100,000 higher than the CY 2023 benchmark (where a lower number is better).

The State failed to meet the benchmark in other quality measures:

• Emergency Department Utilization increased by 1.1 visits per 100,000 and trended 11.1 visits per 100,000 higher than the CY 2023 benchmark (lower is better).
• Persistence of Beta Blocker Treatment after Heart Attack in the commercial market was 14.9 percentage points lower than the CY 2023 benchmark (higher number better); the Medicaid market for this measure remained consistent from Cy 2021 to CY 2022, but was 20.8 percentage points lower (worse) than benchmark in CY 2023.
• Stain Therapy for Patients with Cardiovascular Disease increased from CY 2022 in the commercial market (higher better), but not enough to exceed the CY 2023 benchmark. The Medicaid market was 6.1 percentage points lower (worse) than the CY 2023 benchmark.
• Colorectal Cancer Screening improved from CY 2022 in the commercial market, but did not meet the CY 2023 benchmark. This measure was added for the Medicaid market after the benchmarks were set and will be included in the next benchmarking cycle.

Set by the Delaware Economic and Financial Advisory Committee (DEFAC) Health Care Spending Benchmark Subcommittee, the spending benchmark is a target value for the change from the prior calendar year in state-level per capita total health care expenditures. The methodology incorporates both healthcare and macroeconomic trends. For this report, DHSS collected final/refreshed CY 2022 and new CY 2023 data from commercial, Medicaid and Medicare insurers, as well as from the Veterans Health Administration and the Net Cost of Private Health Insurance.

An interactive quality and spending dashboard updated to include the CY 2023 trend report data released today is available at https://dhss.delaware.gov/dhcc/global.html.

Print