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.  

CostAware Compares Health Care Costs Based on Delaware Medical Claims

NEW CASTLE (March 3, 2023) – The Delaware Department of Health and Social Services (DHSS) announced today the launch of a new version of its 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 initial version of CostAware, launched in April 2022, compared hospital costs for several common episodes of care at six unnamed 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.

In addition to the above data, this version of CostAware includes the following enhancements:

• Average cost estimates for episodes of care 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 investigations and procedures, doctor visits by complexity, 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) to facilitate additional comparisons.
• Additional years of data included – 2020 and 2021 were added to the 2019 data used for CostAware 1.0.
• 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, Medicaid, Medicare Advantage) and patient age range and gender (as appropriate).

“Since its launch last year, CostAware has served as a valuable tool in highlighting the variation in the cost, utilization, and quality of health care in Delaware,” said DHSS Secretary Molly Magarik, who is also a member of the Delaware Health Care Commission. “We are excited for these additional data enhancements, as they add yet another layer of transparency and awareness around the health care dollars that are spent by Delawareans and their insurers.”

CostAware also includes quality measures, 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.

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 (Dec. 4, 2018) – As part of the State Innovation Model (SIM) initiative, the Delaware Health Care Commission has awarded eight additional value-based payment reform mini-grants to Delaware health care providers in order to facilitate data integration, improve the coordination of patient care or increase readiness to integrate into an Accountable Care Organization (ACO) or operate through an Alternative Payment Method (APM)

The awards, through the Value-Based Payment Reform Fund, range from $25,000 to $250,000 for work that must be completed by Jan. 31, 2019. The commission received a total of 45 applications from primary care providers, behavioral health providers, hospitals, Accountable Care Organizations (ACOs), Federally Qualified Health Centers (FQHCs) and clinically integrated networks, all of which must be licensed in the State of Delaware. The commission expects to award a few more additional grants for small projects (up to $50,000) and large projects (up to $250,000), based on the scope of the project.

This round of awards went to:

• Nanticoke Hospital ($250,000): To conduct a study on global budgeting and how it could be implemented by Nanticoke and the State of Delaware.

• MedNet ($200,230): To speed up development of a population health management platform through expedited integration of clinical data from the Electronic Medical Records (EMR) platforms represented across the MedNet network.

• Nemours/A.I. duPont Hospital for Children ($200,000): To increase readiness to integrate into an Accountable Care Organization (ACO) or Clinically Integrated Network (CIN) or operate through an Alternative Payment Method (APM), as well as to ensure data integration/infrastructure analytics and improve coordination of patient care.

• Westside Family Healthcare ($179,190): To improve the Federally Qualified Health Center’s ability to thrive into Alternative Payment Methods (APM) by focusing on utilization of Health Information Technology (HIT) to identify and coordinate care of high-risk/cost patients, identify barriers limiting patients from utilizing the appropriate level of care and develop improved data integration with one of its Medicaid Managed Care (MMC) payers to allow use of clinical data for pay-for-value program performance. Part of the work will involve integration of Westside’s Allscripts Electronic Health Records (EHR) system with the Delaware Health Information Network (DHIN).

• Brandywine Counseling and Community Services ($111,716.50): To implement a data integration project that will reorganize its institutional structure to accommodate value-based payments and improve the coordination of patient care, especially for those clients with co-occurring disorders.

• Stoney Batter Family Medicine ($73,000): To upgrade its Allscripts system to facilitate better data-sharing required for participation in value-based programs, conversion to electronic billing and training sessions for employees.

• Delaware Health Net ($34,375): To develop “cost of care” analytics tool to adequately define the cost of a chronic condition population historically when cared that population has been cared for at a health center.

• Stoney Batter Family Medicine ($20,000): To design a training program for care coordinators/providers on how to prevent emergency department and hospital readmissions utilizing hospital-based admission information from DHIN, its ACO practice dashboard for Medicare patients, and its EHR stem to optimize communication.

“We are excited to announce this next round of mini-grant awards in the area of value-based payment reform,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a board-certified family physician. “These grants reflect a diversity of ways that providers, hospitals, health centers and health systems are embracing payment reform.”

The first award ($62,168), to Christiana Care Health System’s CareLink Behavioral Health Medical Home Pilot, was announced in November. Applications, which were received during the summer, fell into one of three areas:

• Data integration: Project must enhance the applicant’s data integration, clinical informatics or population-based analytics capabilities. Examples include data exchange infrastructure and analytics projects or support; data warehousing and reporting capacity; and development of data-sharing agreements.
• Improve the coordination of patient care: Project must enhance the applicant’s clinical integration. Examples include conducting data analytics and developing care guidelines for a primary care-based system of complex care management for high-risk population(s); implementing improvements in care transitions such as new business processes or mutual agreements with partner providers; and implementing a practice support call center.
• Increase readiness to integrate into an Accountable Care Organization (ACO) or operate through an Alternative Payment Method (APM): Project must develop, expand or enhance the applicant’s shared governance structures and organizational integration strategies, linking the applicant with ACO leadership and across the continuum of care with providers already contracted with an ACO. An example would be support to model costs of care in preparation for participation in value-based payment arrangements with multiple payers.

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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 (Nov. 15, 2018) – As part of the State Innovation Model (SIM) initiative, the Delaware Health Care Commission has awarded the first value-based payment reform mini-grant to Christiana Care Health System to test a new reimbursement model that will also improve the coordination of patient care.

Christiana Care Health System’s CareLink Behavioral Health Medical Home Pilot was awarded $62,168 to test a reimbursement model to foster behavioral health integration within primary care practices focusing on a subset of AmeriHealth Medicaid members with chronic behavioral health conditions as a primary diagnosis.

The Health Care Commission is prepared to award up to multiple applicants in amounts ranging from $25,000 to $250,000 through the Value-Based Payment Reform Fund for work that must be completed by Jan. 31, 2019. The commission has received a total of 45 applications from primary care providers, behavioral health providers, hospitals, Accountable Care Organizations (ACOs), Federally Qualified Health Centers (FQHCs) and clinically integrated networks, all of which must be licensed in the State of Delaware. The commission expects to award grants for small projects (up to $50,000) and large projects (up to $250,000), based on the scope of the project.

“We are pleased to announce the first mini-grant award to Christiana Care as a way for a prominent health care provider in our state to conduct a pilot project in the area of value-based payment reform,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a board-certified family physician. “This is a significant step forward in terms of how health care will be delivered and paid for in Delaware. Additional awards are going through the review and approval process, and we look forward to making those announcements soon.”

“As our work with the State Innovation Model nears its conclusion, the mini-grants are an important milestone for health care providers in our state as they embrace change in health care delivery and plan for long-term sustainability in terms of innovation,” said Dr. Nancy Fan, Chair of the Delaware Health Care Commission. “Along with ongoing work through our practice transformation vendors, the mini-grants will give providers a practical way to facilitate change in the health care landscape.”

Applications, which were received during the summer, fell into one of three areas:

• Data integration: Project must enhance the applicant’s data integration, clinical informatics or population-based analytics capabilities. Examples include data exchange infrastructure and analytics projects or support; data warehousing and reporting capacity; and development of data-sharing agreements.
• Improve the coordination of patient care: Project must enhance the applicant’s clinical integration. Examples include conducting data analytics and developing care guidelines for a primary care-based system of complex care management for high-risk population(s); implementing improvements in care transitions such as new business processes or mutual agreements with partner providers; and implementing a practice support call center.
• Increase readiness to integrate into an Accountable Care Organization (ACO) or operate through an Alternative Payment Method (APM): Project must develop, expand or enhance the applicant’s shared governance structures and organizational integration strategies, linking the applicant with ACO leadership and across the continuum of care with providers already contracted with an ACO. An example would be support to model costs of care in preparation for participation in value-based payment arrangements with multiple payers.

“The Delaware Center for Health Innovation (DCHI) is a public/private partnership that was created after Delaware received a four-year State Innovation Model grant from the Centers for Medicare and Medicaid Innovation,” said Julane Miller-Armbrister, executive director of DCHI. “We support innovative changes in health care delivery and payment in our state in order to drive quality and better health for the people of Delaware. The mini-grants are another step forward in achieving lasting change.”