NEW CASTLE (February 12, 2024) – The Delaware Department of Health and Social Services and the Delaware Health Care Commission have launched the Benchmark Trend Report Dashboard to further support 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.

This dashboard allows an interactive view of Delaware’s health care spending and quality data comparing across multiple years. Users can directly interact with the data and visualizations, allowing a customizable journey through the dashboard. Information is broken down by state-, market- and insurer -level spending as well as type of insurance and total healthcare enrollment.

The spending and quality benchmarks were originally developed to support Governor John Carney’s vision for the State. In November 2018, Governor 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 benchmarks were subsequently codified in August of 2022 through House Bill 442.

“Our goal of ensuring that Delawareans can access and afford quality health care is only possible when agencies across the State work collectively to pursue answers and solutions,” said DHSS Cabinet Secretary Josette Manning. “The benchmarks are a means to continue the conversation about how to decrease the cost of care and improve quality for the individuals we serve.”

To learn more about Delaware’s health care spending and quality benchmarks, visit the Delaware Health Care Commission website at https://dhss.delaware.gov/dhcc/.

NEW CASTLE – The Delaware Department of Health and Social Services (DHSS) announced today enhancements to the CostAware website, designed to help Delawareans understand how their health care dollars are spent by comparing the variation of average costs for different episodes of care and medical services based on actual medical and pharmacy claims in Delaware.

The newest CostAware enhancements include cost comparisons for brand and generic prescription drugs by drug category and payer type (commercial insurance, Medicaid, Medicare Advantage). Also added in this update are average cost comparisons for imaging procedures (head CT, lumbar spine MRI, and screening mammography) by provider organization.

• Prescription Drug Costs compares the average daily cost of brand and generic drugs in Delaware by category and payer type based on 2021 pharmacy claims data. Prescription drugs are identified by National Drug Code (NDC) and grouped into categories assigned based on the condition the drug is intended to treat.
• Imaging by Provider Organization shows the average cost of imaging procedures by payer type, claim year and provider organization. Estimates reflect both the facility cost (taking the image) and professional cost (reading and interpreting the image).

“Delawareans can now compare costs for prescription drugs by drug category and imaging procedures by provider organization to help them make better decisions around their health care,” DHSS Secretary Josette Manning said. “CostAware has served as a valuable tool for Delawareans since its launch in April 2022. These additional data enhancements will bring another layer of transparency around the health care dollars being spent by Delawareans and their insurers.”

In addition to the prescription drug and imaging procedure cost reports, the most recent version of CostAware includes:

• Average cost estimates for episodes of care including C-section births, emergency department visits, knee and hip replacement, and vaginal delivery reported for Delaware hospitals.
• Estimates of the average cost per visit for medical services including child wellness visits, mental and behavioral health services, diabetes care, cardiac procedures, adult doctor visits, and lab tests (blood and urine tests).
• Results reported by care setting including hospital outpatient facility, outpatient lab, professional office, urgent care facility, and telehealth.
• Multiple years of data: Results are reported for 2019, 2020 and 2021.
• Filtering of results by insurance category (Commercial insurance, Medicaid, Medicare Advantage) and patient age range and gender (as appropriate).

The CostAware website was developed by DHSS and the Delaware Health Care Commission (DHCC) in collaboration with Delaware Health Information Network (DHIN).

In early 2020, DHSS and DHCC began working with DHIN to develop and implement various health care cost and quality analyses. These analyses leverage data in the Delaware Health Care Claims Database (HCCD), which was established through legislation passed by the General Assembly in 2016. DHIN manages the claims database and DHSS uses it to inform and support a variety of policy initiatives.

DOVER, DE (March 14, 2023) The Division of Public Health (DPH) is continuing its recruitment push to attract more medical professionals to live and work in Delaware.   

As part of that recruitment effort, DPH, in conjunction with the Middletown-based Epic Marketing Consultants Corporation, developed a recruitment video touting the benefits of being a health care professional in Delaware. The video features a number of health care professionals from across the state, including Lt. Gov. Bethany Hall-Long, MSN, PhD; Dr. Megan Werner, MD, MPH, FAAFP, Westside Family Healthcare; Karyl Rattay, MD, MS, former director of the Delaware Division of Public Health (DPH); and others.  

“It is a home environment, and whether they choose a beach, a rural western area in our state, or if they choose to go to the inner city of Wilmington or in our state capital of Dover, there are a lot of opportunities in the seven health systems,” Lt. Gov. Hall-Long said as part of the recruitment video.  

As Delaware’s population grows and becomes more diverse, health care providers are seeing an increase in demand for a range of services and assistance in various communities across the state. Delaware has a number of federally designated Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs) seeking highly qualified providers in the areas of family practice, pediatrics, internal medicine, gynecology/obstetrics, dentistry, and psychiatry.  

Medical professionals living in Delaware may also be eligible to receive financial benefits — such as National Health Service Corps (NHSC) and state loan repayment opportunities — that position them to get the best return on their investment and can help remunerate medical education expenses.  

• The Delaware State Loan Repayment Program (SLRP) provides educational debt relief to cover a portion of government and commercial loans incurred during one’s health profession education up to $50,000 annually.  
• The Delaware Health Care Provider Loan Repayment Program (HCPLRP) is a state-sponsored educational debt relief program for medical providers, awarding up to $50,000 annually to eligible health care professionals.  
• The National Health Service Corps (NHSC) provides practical experience to physicians around the country and offers financial incentives like the NHSC Loan Repayment Program and the NHSC Scholar Program, both offering tax-free funding for educational expenses.  

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.

NEW CASTLE (May 4, 2022) – The Department of Health and Social Services (DHSS) has launched a state-sponsored Health Care Provider Loan Repayment Program (HCPLRP). Under the new loan repayment program, eligible clinicians may receive up to $50,000 per year in loan repayment for a maximum of four years of employment in Delaware.

Governor John Carney signed House Bill 48 with House Amendment 1 on Aug. 10, 2021, establishing the loan repayment program administered by the Delaware Health Care Commission (DHCC). The program is a valuable tool to incentivize providers to practice in Delaware, in addition to attracting more providers to the state’s primary care workforce.

“We are grateful to Governor Carney and to the General Assembly for their support of the Health Care Provider Loan Repayment Program,” said DHSS Secretary Molly Magarik. “It’s clear that we need to find ways to attract more primary care providers to practice in Delaware, and this state-sponsored program is a strategic way to do that.”

“When it comes to health care, Delawareans deserve to be treated by highly trained professionals at medical facilities statewide,” said Rep. David Bentz, the lead sponsor of House Bill 48. “However, we are facing a shortage of doctors as the demand for them grows. That’s why we passed HB 48, which offers an attractive incentive to Delaware students in residency programs here, as well as establishes an education loan repayment program for medical professionals who currently work in Delaware. With this law, we can work toward recruiting and retaining top primary care doctors. I’m grateful to the Delaware Health Care Commission for taking a leadership role in running the grant program and ensuring that we have more health care workers throughout the state, including in underserved communities.”

In Fiscal Year 2022, the General Assembly allocated $1 million in state funds to support the loan repayment program. The Delaware Health Care Commission also received, in December 2021, a $1 million one-time contribution from Highmark Blue Cross Blue Shield Delaware. For Fiscal Year 2023, beginning July 1, 2022, the Governor’s Recommended Budget has proposed an additional $1 million in state funds to support the program.

“The Delaware Health Care Commission is excited to be able to implement HB48 and offer health care providers, who are interested in practicing in Delaware, worked to address this crisis through the development of the Health Care Workforce Subcommittee; supporting education through Delaware Institute of Medical Education and Research (DIMER) and (Delaware Institute of Dental Education and Research (DIDER); providing practice sustainability through the Primary Care Reform Collaborative; and now incentivizing providers to practice in Delaware with the State Health Care Provider Loan Repayment Program,” said Dr. Nancy Fan, Chair of the Delaware Health Care Commission and a practicing OB/GYN. “We are excited to be able to implement HB48 and offer primary care providers, who will be practicing in Delaware, meaningful financial relief, so they can build a sustainable practice and increase access for our patients to quality, affordable care.”

Qualifying clinicians must be a new primary care provider in an ambulatory or outpatient setting and completed graduate education within six months of the application for HCPLRP being submitted. Eligible health care providers include physicians practicing family medicine, internal medicine, pediatrics, obstetrics/gynecology, geriatrics, and psychiatry as well as Nurse Practitioners, Certified Nurse Midwives, Clinical Nurse Specialists, and Physicians Assistants practicing adult medicine, family medicine, pediatrics, psychiatry/mental health, geriatrics, and women’s health.

Employers may apply on behalf of their affiliated, qualifying clinicians for education loan repayment grants. These sites may include:
• Hospital primary care practices
• Private practices
• Federally Qualified Health Centers
• Community outpatient facilities
• Community mental health facilities
• Free medical clinics

For awards issued to practitioners employed by Delaware health care facilities, hospitals and health systems must provide a 50% match for loan repayment awards.

Priority consideration will be given to Delaware Institute of Medical Education and Research (DIMER)-participating students and participants in Delaware based residency programs. Delaware is one of four states that does not have its own medical school. To accommodate the growing demand for primary care physicians across the state, the General Assembly created DIMER to support affiliated agreements with two medical schools in Philadelphia: Philadelphia College of Osteopathic Medicine (PCOM) and Thomas Jefferson, Sidney Kimmel Medical College (SKMC). A minimum of 120 academic seats are reserved annually (80 at Sidney Kimmel and 40 at PCOM) for Delaware residents applying to an allopathic or osteopathic degree program. New DIMER graduates are eligible for HCPLRP.

Delaware’s Health Care Provider Loan Repayment Program application is available online.

Applications are now accepted on a rolling basis and will be reviewed on the following schedule:
June 1, 2022*
Aug. 1, 2022*
Oct. 1, 2022

* Applicants in the June 1 and August 1 review cycles must have completed their graduate medical education by July 2021 or sometime thereafter. Applicants in the Oct. 1 review cycle must complete their graduate education by 2022 or sometime thereafter.

In addition to the state-sponsored Health Care Provider Loan Repayment Program, Delaware has operated a federal state loan repayment program (SLRP) supported by the Health Resources and Services Administration of the U.S. Department of Health and Human Services. SLRP offers similar incentives: up to $200,000 for four-year contractual agreements to provide services in federally designated Health Professional Shortage Areas. Where SLRP differs from HCPLRP is in designated areas of need, eligible professional disciplines, types of health care employment facilities that qualify, and date of graduation in respective disciplines.

To learn more about Health Care Provider Loan Repayment Program and the federal state loan repayment program, visit the Health Care Commission’s website.

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The Department of Health and Social Services is committed to improving the quality of life of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.