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.

NEW CASTLE (April 7, 2022) – The Department of Health and Social Services (DHSS) has launched a new website called CostAware 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.

Hospital costs are compared for five common episodes of care at six hospital systems: cardiac procedures, C-section birth, emergency department visits, knee and hip replacement, and vaginal delivery. The costs across five accountable care organizations (ACOs) are also compared for seven common services: blood count, colonoscopy, doctor visits, hemoglobin A1c, head CT, lumbar spine MRI and screening mammography. The rates are based on 2019 medical claims in the Delaware Health Care Claims Database and reflect the cost that consumers and their insurers actually paid for the care.

In addition, quality measures are provided, including the readmission and utilization rates, and patient satisfaction scores, all from the Centers for Medicare and Medicaid Services (CMS) as part of its Hospital Compare and Medicare Shared Savings Program initiatives. Each episode of care and service can be filtered further by the type of insurance: commercial, Medicare Advantage and Medicaid.

“This kind of transparency and public awareness of health care spending is important for everyone in the system – consumers, health care providers, taxpayers, insurers and businesses,” said DHSS Secretary Molly Magarik, who is also a member of the Delaware Health Care Commission. “We all want good value for the health care dollars we do spend. CostAware offers a glimpse into the actual costs that Delawareans and their insurers are paying, and the quality measures associated with that care.”

In this initial version of CostAware, the Delaware hospital systems and accountable care organizations are not identified. Secretary Magarik said she hopes to include that information in future versions of the website.

The site also breaks down the average monthly cost of care for each member of an accountable care organization and the top procedures for several age and gender groups based on overall volume and dollar volume.

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

CostAware is the result of goals from that partnership that include expanding the claims database analysis, measurement and reporting capabilities to increase transparency; highlighting variation in health care system performance; adding to consumers’ knowledge base; and identifying opportunities to improve quality and reduce costs for Delaware residents.

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.

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

Latest Step in Effort to Reduce Cost, Improve Quality of Care in Delaware

DOVER (April 1, 2021) – Department of Health and Social Services (DHSS) Secretary Molly Magarik presented the state’s first Benchmark Trend Report at today’s Delaware Health Care Commission (DHCC) meeting, summarizing health care spending and quality data collected for calendar year 2019. The report is the latest step in the state’s effort to reduce health care spending and improve quality of care for Delawareans.

The Benchmark Trend Report details total health care spending for 2019 and compares it to baseline data collected for 2018. In late 2018, Governor John Carney 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.

For calendar year 2019, the report found overall health care spending in Delaware totaled $8.2 billion vs. $7.6 billion for 2018. The per-capita cost increased from $7,814 in 2018 to $8,424 in 2019, or 7.8% – more than twice as high as the 3.8% target. Spending in 2019 increased across all spending categories, including the five largest:

• Hospital inpatient: $1.8 billion (up from $1.6 billion in 2018)
• Hospital outpatient: $1.6 billion (up from $1.4 billion in 2018)
• Physician: $1.3 billion (up from $1.2 billion in 2018)
• Pharmacy: $1.2 billion (up from $1.1 billion in 2018)
• Long-term care: $1.1 billion (up from $1 billion in 2018)

“This kind of transparency and public awareness of health care spending is important for everyone in the system – health care providers, consumers, taxpayers, insurers and businesses,” said Secretary Magarik, a member of the Health Care Commission. “The next step is to work with health care providers, insurers, government agencies and consumers to transform the delivery of health care away from volume-based case to value-based care to be consistent with the overall economic growth of the state.”

The report also provided results on six health care quality measures; Delaware improved on two measures, split on one measure, and worsened on three others:

Improved

Adult tobacco use: The benchmark rate for 2019 was to reduce the percentage of Delaware adults who smoke to 17.1%. The 2019 result: 15.9%.
Statin therapy for patients with cardiovascular disease: The benchmark rate for 2019 was to increase the percentage of commercial insurance patients who receive statin therapy to 79.9% and for Medicaid patients to 59.2%. The 2019 results: 85.3% for commercial insurance patients; 65.1% for Medicaid patients.

Split

Persistence of beta-blocker treatment after a heart attack: The benchmark rate for 2019 was to increase the percentage of commercial insurance patients who receive beta-blocker treatment to 82.5% and to 78.8% for Medicaid patients. The 2019 results: 93.9% for commercial insurance patients, but 73.5% for Medicaid patients.

Worsened

Adult obesity: The benchmark for 2019 was to reduce the percentage of Delaware adults who are obese to 30%. The 2019 result: 34.4%.
Opioid-related overdose deaths: The benchmark for 2019 was to reduce the mortality rate to 16.2 deaths per 100,000. The 2019 result: 43 deaths per 100,000.
Emergency department utilization: The benchmark for 2019 was to reduce the rate to 190 visits per 1,000. The 2019 result: 193.2 visits per 1,000.

“While we made progress as a state in reducing adult tobacco use and increasing the use of statins for patients with heart disease, we have much more work to do reduce the adult obesity rate, deaths from opioid overdoses and emergency department utilization,” Secretary Magarik said. “Working together, I know we can make more progress in improving the overall health of Delawareans.”

The Delaware Health Care Commission previously collected spending data from calendar year 2018 to provide a preliminary basis for calculating the state’s health care spending performance and to serve as a baseline for the 2019 spending growth calculations. The 2018 baseline data collection also allowed the state’s health insurers and the DHCC to test payers’ data-submission methods and identify areas for improvement.

The release of the 2019 spending and quality data is another step along the state’s “Road to Value” initiative to improve access to affordable, quality health care for all Delawareans. That effort remains critically important even as Delaware responds to the COVID-19 crisis, Secretary Magarik said.

“As our state continues to respond to the global pandemic, we will need to support the health care system with value-based goals, knowing that too many Delawareans have put off their health care needs,” Secretary Magarik said. “The Benchmark Trend Report will help us to focus those goals.”

The Heath Care Commission is accepting written public comments on the Benchmark Trend Report through Friday, April 9, at: DHCC@delaware.gov. To learn more about Delaware’s health care spending and quality benchmarks, visit the Delaware Health Care Commission website.

Report Is Latest Step in Effort to Analyze Cost and Quality of Care in Delaware

DOVER (June 4, 2020) – The Delaware Health Care Commission (DHCC) has released preliminary data on health-care spending in the state in calendar year 2018, the latest step in the state’s effort to reduce health care spending and improve quality of care for Delawareans.

The report, available here, follows the establishment in late 2018 of a state health care spending benchmark, a per-annum rate-of-growth benchmark for health care spending. The first benchmark went into effect Jan. 1, 2019, and was set at 3.8 percent, with the target expected to decrease gradually to 3.0 percent over the following three years.

The DHCC collected spending data from calendar year 2018 to provide a preliminary basis for calculating the state’s health care spending performance and to serve as a baseline for 2019 spending growth calculations. The 2018 baseline data collection also allowed the state’s health insurers and the DHCC to test payers’ data-submission methods and identify areas for improvement.

The DHCC is scheduled to collect 2019 medical expense data from insurers this summer. As part of the next round of benchmark data collection, health care insurers will be asked to resubmit their 2018 data to incorporate any updates to collection methods to ensure better year-over-year comparisons. Because of that, the DHCC expects the next set of 2018 data to differ from that released today.

The state plans to release its 2019 health-care spending performance as measured against the 3.8 percent benchmark early next year.

The release of the preliminary spending data from 2018 marks another step along the state’s “Road to Value” initiative to improve access to affordable, quality health care for all Delawareans. That effort remains vitally important while Delaware addresses the impact of the COVID-19 crisis, said Dr. Kara Odom Walker, secretary of the Department of Health and Social Services, a member of the Delaware Health Care Commission and a practicing family physician.

“We need to support our health care system to rebound from the global pandemic with value-based goals so it can be stronger than ever,” Secretary Walker said. “Now, more than ever, our vision to improve transparency and public awareness of spending and quality in our state through the adoption of spending and quality benchmarks will assist in these efforts.”

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

NEW CASTLE (October 9, 2019) – The Department of Health and Social Services (DHSS) is seeking applications from Delaware health care providers for one-time, health information exchange (HIE) support mini-grants to adopt the full range of health information exchange tools offered by the Delaware Health Information Network (DHIN).

DHIN is Delaware’s Health Information Exchange (HIE) and holds more than 2.9 million patient records. Additionally, DHIN allows the safe and secure delivery of clinical results and reports for patients, along with admission and discharge data from all Delaware acute-care settings and more than 46 long-term care facilities.

Eligible mini-grant applicants include small primary care and other medical practices, behavioral health providers, accountable care organizations (ACOs), or Federally Qualified Health Centers (FQHCs) that are not adopting the full range of health information exchange tools offered by the DHIN. All applicants must be licensed in Delaware and must provide a valid medical license where applicable. Applications will be evaluated by the Delaware Health Care Commission.

“This mini-grant opportunity will help primary care practices to serve their patients more effectively by enriching the electronic data they have available for each patient,” said Department of Health and Social Services Secretary Dr. Kara Odom Walker, a practicing family physician. “The mini-grants also will help primary care practices to prepare for value-based care and improving health, which are critical to reducing the overall cost of health care across the spectrum.”

“DHIN is thrilled to work with the Department of Health and Social Services to bring data services to the health care providers of Delaware in support of treatment decisions at the point of care as well as care coordination, patient engagement, and data analytics,” said Dr. Jan Lee, CEO of the Delaware Health Information Network.

This mini-grant is an opportunity for practices to expand their use of data as a lever in preparation for new payment models, including Total Cost of Care (TCC) and risk-sharing arrangements by having connectivity with the DHIN. To achieve this outcome, these mini-grants will support investments in EMRs (Electronic Medical Records), proper technology infrastructure, and DHIN-bundled services, with the ultimate goal of contributing data to and receiving data from the DHIN. This one-time funding is being offered to assist medical practices to adopt the full range of health information exchange tools offered by the DHIN. These services include:

• Access to the Community Health Record (CHR), the longitudinal view of each patient’s health data regardless of place and date of service.
• A results-delivery interface that enables DHIN to securely deliver all result types from all data senders directly into the provider’s Electronic Health Record (EHR).
• Care Summary Exchange, which enables the provider to send a summary of each clinical encounter to the DHIN, thus enriching the data within the CHR for all users.
• Event Notification Services (ENS), by which DHIN can notify the provider or a designated care coordinator of admissions or discharges of their patients to approximately 200 hospitals, emergency departments (EDs), and other care settings across Delaware, Maryland, West Virginia, District of Columbia, southern New Jersey, and selected Pennsylvania EDs.
• Patient Portal/Personal Health Record (PHR), co-branded for the practice, by which a participating patient can view all their health data submitted to DHIN by all sources. The DHIN PHR is certified by the Office of the National Coordinator for Health Information Technology to meet all requirements for patient engagement under Meaningful Use and the Merit-Based Incentive Payment System.
• Medication history, activated through the CHR, which enables on-demand retrieval of a 12-month prescription fill history, thus facilitating medication reconciliation.

The Delaware Health Care Commission (DHCC) is prepared to award up to 25 applicants in varying amounts, with the maximum award total of $8,000, to assist practices with start-up costs. Funding is being made available through the Department of Health and Social Services’ Fiscal Year 2020 budget.

The DHCC will accept applications on a rolling admission and are due no later than Nov. 30, 2019. Applications will be evaluated and considered as they are received. Final notifications of award will be sent by Dec. 15, 2019. All questions and final applications must be submitted by email to DHCC@delaware.gov.