New Report Outlines Plan for Strengthening Primary Care in Delaware

Provisional Affordability Standards aim to strengthen primary care in Delaware through increased investment

Insurance Commissioner Trinidad Navarro announced the release of the Office of Value-Based Health Care Delivery’s initial provisional Affordability Standards as part of a new report, Delaware Health Care Affordability Standards: An Integrated Approach to Improve Access, Quality and Value, which includes plans to more than double primary care spending in the commercial fully-insured market by 2025.

The Affordability Standards announced today also include decreasing price growth for certain healthcare services and expanding the use of payment models that aim to improve healthcare value. The Affordability Standards and targets were informed by data from Delaware health insurers, the Delaware Health Information Network Health Care Claims Database, publicly available sources, and the perspectives shared during more than two dozen stakeholder interviews.

“An effective healthcare environment requires a strong primary care system, but it also requires shared standards that define success and progress. The multi-pronged approach announced today aims to increase primary care investment without increasing the total cost of healthcare or health insurance premiums,” Commissioner Navarro said. “We are grateful to our many partners who shared their data and experience during the process of building these guidelines. Now we ask the public as a whole to share their feedback on this report.”

The department will be accepting public comment on the report until January 25, 2021. Anyone may submit comments via email to DOI-legal@delaware.gov.

The Office of Value-Based Health Care Delivery was created through the passage of Senate Substitute 1 for Senate Bill 116 in 2019. The General Assembly recognized the importance of a strong system of primary care and the need to help bend the healthcare cost growth curve, directing the department to establish the office in order to “reduce health-care costs by increasing the availability of high quality, cost-efficient health insurance products with stable, predictable, and affordable rates,” and charged the office with three tasks:

1. Establish Affordability Standards for health insurance premiums based on recommendations from the Primary Care Reform Collaborative and annually monitor and evaluate these standards;
2. Establish targets for carrier investment in primary care to support a robust system of primary care by January 1, 2025; and
3. Collect data and develop annual reports regarding carrier investments in health care, including commercial reimbursement rates for primary and chronic care services.

The Office is meeting these directives by conducting extensive research on Delaware’s healthcare market, and used that research to inform the development of the interim Affordability Standards, including targets for increased investment in primary care.


Delaware’s First Mental Health Parity Examinations Complete

Regulated health insurers found to be in violation laws of that prohibit discrimination in mental healthcare, $597K in fees assessed

Insurance Commissioner Trinidad Navarro has announced the completion of the first in a series of Mental Health Parity examinations on health insurers in Delaware. Investigations conducted by the Delaware Department of Insurance uncovered thousands of mental health parity violations, resulting in $597,000 in fines thus far. The exams are ongoing and include each of the four major insurers. The department works with each insurer to correct issues and create a less discriminatory environment in the future. The 2018 passage of SB 230 required companies to submit an initial analysis of mental and behavioral health coverage to the department in 2019, after which the department would include compliance reviews in their annual market conduct exams. A high number of violations was expected due to this being the first assessment by the department.

“After an incredibly thorough review, our team identified many changes that needed to be made to improve parity. Today’s announcement shows that there is more work to do to ensure those seeking mental health care can do so without undue expense or difficulty. I will continue to hold insurers accountable to meet our state’s standards,” said Commissioner Navarro. “Each violation incurred a fine, but it also brought about important conversations that will result in action, and insurers have been cooperative throughout the process and are already making improvements. We will be following up with insurers frequently and expecting substantial progress.”

Mental Health Parity laws, which exist both at the state and federal levels, aim to eliminate coverage discrimination between policyholders seeking mental illness or substance abuse care and those seeking physical care. A lack of parity can prevent a person from pursuing needed care due to cost or limited access, or otherwise make it more expensive or more time intensive than medical visits. Department examinations are critical to uncovering parity issues as consumers may not be aware if they are experiencing disparate treatment when seeking substance abuse or mental health care.

“Everyone deserves equal access to equal treatment. Mental Health Parity has been a priority of mine and the Behavioral Health Consortium. I want to thank Commissioner Navarro and his department for conducting these examinations and advocating for persons suffering with mental health and substance use disorder,” said Lt. Governor Bethany Hall-Long. “Everyone should be able to access the level of care required for the duration and intensity of their behavioral health needs. Persons should be able to access treatment based on the acuity and severity of their health condition or recovery needs and should never be denied treatment due to insurance practices driven by cost and quotas. This practice has adversely impacted outcomes for persons suffering with mental health and addiction.”

“Making progress on mental health parity has been a priority for our office for several years,” said Navarro, “but this year has emphasized the importance of this task. COVID-19, and all the stress, isolation, anxiety, and grief that has come with it has amplified the need for mental health care access, while also in many ways destigmatizing utilization of services.”

In general, the violations found in policies and practices revolved around a lack of parity between mental health and medical/surgical procedures, medications and procedure preauthorization requirements. Mental health patients often had to meet higher standards for Non-Quantitative Treatment Limitation (limits on the scope or duration of benefits) than other patients, and pharmacy requirements appeared to differ as well. The companies are working to resolve these differences.


Delaware Finalist for International Insurance Domicile of the Year

Shortlisted for European Captive Review honor

Insurance Commissioner Trinidad Navarro shared today that Delaware was named as one of three finalists for International Insurance Domicile of the Year within the European Captive Review Awards. The winning domicile will be announced in a virtual ceremony on November 26. Delaware is the fifth largest global captive domicile. Commissioner Navarro commended his staff and highlighted their experience and fluency in multiple languages as key attributes to the department’s success.

“With speakers of French, German, Lithuanian, Russian, and Spanish, and decades of experience in international captive matters, the Delaware Department of Insurance Captive Division has a worldwide presence that far exceeds our size,” said Commissioner Navarro, adding that the department’s work on international regulation is prominent in the industry. “Our team participates in supervisory colleges with other jurisdictions around the world to successfully coordinate insurance regulation on a global scale.”

In addition to the recent short-list announcement, the department’s captive team is one of only four captive domiciles to be trained and certified by the International Center for Captive Insurance Education. In 2019, Delaware was named a finalist for Non-Asian Domicile of the Year by leading industry magazine Captive Review.

To learn more about the Delaware Department of Insurance Captive Division, visit captive.delaware.gov.


Workers’ Comp. Insurance Rates Drop for Fourth Consecutive Year

Decrease and Workplace Safety Program save businesses money during unprecedented time

Insurance Commissioner Trinidad Navarro announced today that workers’ compensation insurance rates will decrease for the fourth year in a row, effective December 1, 2020. The voluntary market is seeing yet another double-digit decrease in loss costs, with an average 11.56% reduction, and residual market rates will go down an average of 8.8%.

“For four consecutive years we have been able to decrease workers’ compensation costs for businesses of all sizes. This year’s reduction will help decrease business expenses as we continue to experience the economic effects of the COVID-19 pandemic,” said Commissioner Navarro. “These lower costs can attract new companies to our state and increase employment opportunities as many organizations look to move out of major metropolitan areas.”

The Delaware Compensation Rating Bureau (DCRB) approved the lower rates after discussion with the Department of Insurance and the State’s Ratepayer Advocate. The approval process includes a review by actuaries for the parties, as well as a public hearing. It is important to note that actual savings may differ and will vary by policy. Last year’s decreases saved businesses more than $4 million in premiums.

These lower rates are just one component of several efforts shepherded by the Department to help businesses financially. More than 1,100 employers are saving even more money on their workers’ compensation premiums by participating in the department’s Workplace Safety Program. Last year’s savings was approximately $7.6 million. Eligible businesses can earn up to a 19% discount on their insurance by providing and maintaining a safe place to work.

“Now more than ever, increasing workplace safety and decreasing business overhead is so important,” said Commissioner Navarro. “Our inspectors are working extremely hard to negotiate challenges caused by COVID-19 and are doing an impressive job completing safety audits during these extraordinarily unusual circumstances. I want to commend them and our entire Workplace Safety team for their incredible work.”

Eligible businesses are notified about the program each year seven months prior to their renewal date, but late applications are being accepted as many businesses were closed when they were notified of their eligibility. Organizations interested in participating can access questionnaires online and contact safety@delaware.gov to begin the process.

Interested employers are urged to note on their questionnaires their current hours and best point of contact if these have been adjusted due to COVID-19 so inspectors can plan site visits. A physical walkthrough is still required for employers to earn a safety discount. Only benefits can be gained by participating, failure to qualify cannot be the basis for premium increases or sanctions imposed by other safety enforcement officials.

View the DCRB website


Overdose Medication Distribution Planned For Smyrna Wednesday

Commissioner Navarro to provide Naloxone kits and training at event

Insurance Commissioner Trinidad Navarro, in collaboration with Public Health’s Kent County Community Response Team, the First Presbyterian Church of Smyrna, and the Smyrna-Clayton Ministerium will provide free training and opioid rescue kits to residents on Wednesday, October 14 from 2:00 to 5:00PM. The event, taking place outdoors at the First Presbyterian Church of Smyrna, 118 W. Commerce St. will offer both drive-through and walk up options in order to maintain social distancing.

“Amidst the COVID-19 pandemic, we can’t forget about the opioid epidemic. Addiction has its grip on our community, and with this event and others, we can make sure that Naloxone gets to individuals and families who may need it during an opioid overdose emergency” said Commissioner Navarro. “While we continue to work to ensure that treatment for those with drug dependencies is affordable and accessible, events like these offer an opportunity to increase awareness and education life-saving techniques and tools.”

Attendees will spend roughly ten minutes being trained to recognize and respond to an opioid overdose emergency, as well as learning about local treatment and support resources. Opioid Rescue Kits, each containing two doses of Naloxone, an opioid overdose reversal medication, will be distributed. Residents who are at risk of experiencing and overdose, or individuals whose loved ones may be at risk, are strongly encouraged to attend.

If you or a loved one are struggling with substance abuse, do not wait, find help today. The Division of Substance Abuse and Mental Health launched the 24/7 Hope line to serve as a single point of contact for resources, info, clinical and peer support, and crisis assistance. Call 1-833-9-HOPEDE or visit HelpisHereDE.com.

Any residents having problems obtaining insurance approval for treatment or prescriptions related to substance abuse or mental health needs, contact the Delaware Department of Insurance’s Consumer Services Division by emailing consumer@delaware.gov or calling (302) 674-7300.

Event attendees and media representatives must observe social distancing and wear a face covering.

NOTE TO MEDIA: If you plan to attend, please RSVP to Christina.Haas@Delaware.gov.