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.

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.

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.