NEW CASTLE (July 12, 2023) – 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 claims in Delaware.

In early 2020, DHSS and the Delaware Health Care Commission began working with Delaware Health Information Network (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.

The newest CostAware enhancements include additional quality measures from the Centers for Medicare & Medicaid Services (CMS), generated under the Hospital Compare and Medicare Shared Savings Program initiatives, and information on the top medical procedures performed in Delaware.

• Quality measures for Accountable Care Organizations (ACOs) include patient rating of provider; access to timely care; appropriate treatment for diabetes, cardiovascular disease, high blood pressure and depression; and screening rates for breast and colon cancer.
• Hospital quality measures include:
  • Patient experience, e.g., rating of nurse and doctor communications; receiving timely help; and overall experience of care.
  • Patient safety, e.g., rates of early elective deliveries, complications/readmissions after hip or knee replacement, and readmission after discharge (all causes).
• Top procedures reports show the top 10 medical procedures performed in Delaware based on both the number of claims and total spending. These reports can be filtered by gender, age group, and year.

“Since its initial launch in April 2022, CostAware has served as a valuable tool to help Delawareans understand how their health care dollars are being spent,” said DHSS Secretary Molly Magarik, who is also a member of the Delaware Health Care Commission. “These latest enhancements add yet another layer of transparency while focusing on patient experience and safety, which will further empower consumers to receive good value for their health care dollars.”

In addition to the enhanced quality measures and top procedures reports, the most recent version of CostAware (updated in March 2023) includes:

• Average cost estimates for episodes of care including C-section births, emergency department visits, knee and hip replacement, and vaginal delivery reported for named Delaware hospitals.
• Estimates of the average cost per visit for additional 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 type of care setting (e.g., hospital outpatient facility, outpatient lab, professional office, urgent care facility, and telehealth).
• Multiple years of data – Results are reported for 2019, 2020 and 2021.
• Trend visualizations, with multiple years of data, show changes over time in average cost, quality, and other measures.
• Improved filtering of results by insurance category (Commercial insurance, Medicaid, Medicare Advantage) and patient age range and gender (as appropriate).

“Delawareans can now see the differences in cost for very common medical procedures and services, so they can make better decisions around their health care,” said DHSS Director of Healthcare Reform Steven Costantino. “Seeing the variation in the cost, utilization, and quality of health care is critical for everyone in the system – consumers, health care providers, taxpayers, insurers and businesses.”

Early in his administration, Governor John Carney said one of the most important things he could do as Governor is to slow the growth of health care spending. In late 2018, the Governor 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. The first benchmark report measured the growth rate at 7.8% for 2019, or more than twice the 3.8% target. This has proven to be an invaluable initiative, which lead to it being codified in 2022 through House Amendment 1 for House Bill 442.

The CostAware website was developed by DHSS and the Health Care Commission in collaboration with DHIN.

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