DHSS Releases Second Annual Health Care Benchmark Trend Report

NEW CASTLE (May 5, 2022) – Department of Health and Social Services (DHSS) Secretary Molly Magarik presented the State’s second annual Benchmark Trend Report at today’s Delaware Health Care Commission (DHCC) meeting. This report displays trends in Delaware’s health care spending and quality, comparing new 2020 data against a set benchmark, as well as baseline data from 2019. This report continues the State’s efforts to improve health care quality for all residents, while simultaneously working to monitor and reduce the economic burden of health care spending.

In November 2018, Governor John Carney signed Executive Order 25, establishing a state health care spending benchmark, an annual per-capita-rate-of-growth benchmark for health care spending, and multiple health care quality measures that are to be evaluated and adjusted every three years.

The first spending benchmark went into effect on Jan. 1, 2019, and was set at 3.8%. That spending benchmark was not met, as the finalized health care spending for 2019 grew at a rate of 5.8%. For calendar year 2020, the spending benchmark was set at a more ambitious target of 3.5%. This benchmark was met as the 2020 Total Health Care Expenditures (THCE) per-capita change from the prior year was estimated at -1.2%. Total expenditures encompass health care spending associated with Delaware residents from private and public sources. Total Health Care Expenditures increased by $39 million in calendar year 2020, totaling $8.1 billion. However, with Delaware’s population increasing by 1.7% from 2019 to 2020, the per-capita total decreased from $8,268 in 2019 to $8,173 in 2020.

“While the decreases in per-capita health care spending and the spending growth rate appear at first glance as a positive change, it is important to note that the COVID-19 pandemic had a significant impact on preventative health care services, health care facility utilization, service delivery, and payer/provider finances,” Secretary Magarik said. “These benchmark findings need to be viewed in the context of the extraordinary circumstances we faced in 2020. And that makes equitable comparisons with previous calendar years extremely difficult.”

“The report continues to showcase the need to lower costs and improve quality in Delaware,” said Steven Costantino, DHSS’ Director of Health Care Reform. “We need to continue to move toward a more value-based care system so that health care is more affordable for all Delawareans. The benchmark has proven to be a useful tool in driving reform and targeting initiatives to improve health care delivery.”

The 2020 Trend Report also provides insight into Delaware’s health care quality by presenting data on six quality measures.

“Unfortunately, the results of the quality measures are mixed,” Secretary Magarik said. “While Delaware made progress in some important measures, the report shows us there is still significant work to be done to improve the health of Delawareans in other areas. At DHSS, we look forward to working with health care providers, insurers, legislators, businesses, other government leaders and, most importantly, consumers to help build a healthier Delaware.”

Overview of Quality Results:

  • Adult obesity: The benchmark for 2020 was to reduce the percentage of Delaware adults who are obese to 29.4%. The 2020 result: 36.5%; an increase from 2019 and 7.1 percentage points higher than the benchmark.
  • Use of opioids at high dosages: This is a new benchmark for 2020, which used the Delaware Prescription Monitoring Program to observe the rate at which high-dose opioids were prescribed. The 2020 benchmark: 12.4%; the 2020 result: 11.1%. This is a positive observation.
  • Opioid-related overdose deaths: The benchmark for 2020 was to reduce the mortality rate to 15.5 deaths per 100,000. The 2020 result: 43.9 deaths per 100,000. This is an increase from 2019.
  • Emergency department utilization: The National Committee for Quality Assurance (NCQA) significantly changed the methodology for this quality measure, so it was given first-year status and no calendar year 2020 data was reported.
  • Persistence of beta-blocker treatment after a heart attack: The benchmark rate for 2020 was to increase the percentage of patients who receive beta-blocker treatment to 84.9% of commercial insurance patients and to 80.1% for Medicaid patients. The 2020 results: 91.7% for commercial insurance patients and 78.1% for Medicaid patients. While the Medicaid patients did not reach the benchmark, this is a significant improvement from the 2019 results of 73.5%.
  • Statin therapy for patients with cardiovascular disease: The benchmark rate for 2020 was to increase the percentage of patients who receive statin therapy to 80.5% of commercial insurance patients and 61.5% for Medicaid patients. The 2020 results: 83.6% for commercial insurance patients; 72.6% for Medicaid patients. For both markets, results were better than the respective benchmark.

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


State Releases Preliminary Look at Health Care Spending in 2018

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.

 


DHSS Secretary Dr. Kara Odom Walker Elected to Prestigious National Academy of Medicine

NEW CASTLE (Oct. 15, 2018) – Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a board-certified family physician, has been elected as a member of the prestigious National Academy of Medicine (NAM), Academy President Victor Dzau announced today during the organization’s annual meeting in Washington.

Secretary Walker is one of 75 new members this year from across the country and 10 international members. Membership in the National Academy of Medicine is considered one of the highest honors in the fields of health and medicine, and recognizes individuals who have demonstrated outstanding professional achievements and commitment to service.

“I congratulate Dr. Walker on being elected to the National Academy of Medicine,” Governor John Carney said. “Dr. Walker uses her problem-solving, outreach and leadership skills to take on such complex issues in our

state as the opioid epidemic and the rising growth in health care spending. She doesn’t back way from these issues. She leans in, bringing people together, using data and other resources to assess situations, and changing systems to better serve the people of our state.”

Secretary Walker was sworn in as Cabinet Secretary for DHSS in February 2017, leading the principal agency charged with keeping Delawareans healthy, ensuring they get the health care they need in a fast-changing world, and providing children, families and seniors with essential social services including food benefits, disability-related services, and mental health and addiction treatment. She oversees one of the largest departments in Delaware’s government with an annual budget of more than $2 billion. As Cabinet Secretary, her priorities include:

• Slowing the growth of health care spending, increasing the transparency of health care costs and improving patient outcomes.
• Bolstering the state’s response to the opioid epidemic with increased resources for treatment, harm reduction and prevention.
• Reducing gun violence in Wilmington by meeting the social services needs of high-risk young people and their families.
• Maintaining a strong safety net for those in need.
• Providing more community-based services for seniors, people with disabilities and individuals who are homeless.

Prior to being nominated to head DHSS by Governor Carney, Secretary Walker worked as the Deputy Chief Science Officer at the Patient-Centered Outcomes Research Institute (PCORI), a nonprofit, nongovernment organization in Washington that is authorized by Congress to improve evidence available to help patients, caregivers, employers, insurers and policymakers make informed health care decisions. She managed the Institute’s research investments, which totaled $1.6 billion in 2016, toward a planned total of $2.5 billion by 2019.

“Those of us who had the great pleasure to work with Kara during her four and a half years at PCORI are thrilled with her well-earned election to the National Academy of Medicine,” said Joe V. Selby, MD, MPH, Executive Director of the Patient-Centered Outcomes Research Institute. “It recognizes the diligent work and exceptional contributions she’s made at every stop throughout her training and career. She brings tremendous knowledge and insight to the Academy as it pursues its mission of improving health for all.”

Background in teaching, serving

Secretary Walker formerly taught Family and Community Medicine at the University of California, San Francisco, as an Assistant Clinical Professor, and has worked with several national organizations to advocate for health equity and for access to quality health care in minority and underserved populations, including the National Medical Association, the Student National Medical Association and the American Medical Association. Dr. Walker has been recognized for leadership by Harvard Business School’s Program for Leadership Development, the American Medical Association and the National Medical Association.

Kevin Grumbach, MD, the Hellman Endowed Professor and Chair of the University of California, San Francisco (UCSF) Department of Family and Community Medicine, nominated Dr. Walker for the honor. “Dr. Walker’s election to the National Academy of Medicine recognizes her career-spanning roles as a family physician and community health leader in academic medicine, the Patient-Centered Outcomes Research Institute, and state government who has championed health equity and consumer and community engagement,” Dr. Grumbach said. “In her current role as Cabinet Secretary at the Delaware Department of Health and Social Services, she has addressed social determinants of health by making Delaware a state with one of the highest percentages of eligible families enrolled in the Supplemental Nutritional Assistance Program and fathers paying child support, and by launching new community-based violence prevention programs. She has rapidly emerged as one of her generation’s most influential family physicians.”

A Caravel Academy high school graduate, she earned her bachelor’s degree in chemical engineering from the University of Delaware and her medical degree from Jefferson Medical College in Philadelphia. She has a Masters of Public Health from the Johns Hopkins School of Public Health and a Masters in Health Services Research from the University of California, Los Angeles, School of Public Health, where she also completed a post-graduate fellowship in the Robert Wood Johnson Clinical Scholars program. As a family physician, Dr. Walker has provided direct patient care in many primary care settings, including those for uninsured and underserved populations. She has published research papers on physician workforce issues, health care organization and delivery.

“The College of Engineering at the University of Delaware would like to congratulate Dr. Walker for her well-deserved election to the National Academy of Medicine,” said Levi T. Thompson, Dean of UD’s College of Engineering and an alumnus of UD’s chemical engineering program. “Her studies in chemical engineering at UD were the starting point of an educational journey that prepared her well to tackle grand challenges in health and public policy. Now, she is using her skills and knowledge to improve the health, safety and quality of life for people in Delaware and across the nation. We could not be more proud of Dr. Walker and look forward to her continued successes.”

The National Academy of Medicine, established in 1970 as the Institute of Medicine, is an independent organization of eminent professionals from diverse fields, including health and medicine; the natural, social and behavioral sciences; and beyond. It serves alongside the National Academy of Sciences and the National Academy of Engineering as an adviser to the nation and the international community. Through its domestic and global initiatives, the Academy works to address critical issues in health, medicine and related policy, and inspire positive action across sectors.

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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.


Health Care Commission Seeks Applications from Delaware Health Care Providers for One-Time Mini-Grants Related to Payment Reform

NEW CASTLE (July 26, 2018) – As part of the State Innovation Model (SIM) initiative, the Delaware Health Care Commission is seeking applications from Delaware health care providers for one-time, value-based payment reform mini-grants to grow their capacity to integrate data, improve the coordination of patient care or increase their readiness to integrate into a total cost of care or Alternative Payment Model (APM).

The Delaware Health Care Commission is prepared to award up to 10 applicants in amounts ranging from $25,000 to $250,000 through the Value-Based Payment Reform Fund for work that must be completed or services procured by Jan. 31, 2019. Mini-grant applicants must be primary care providers, behavioral health providers, hospitals, Accountable Care Organizations (ACOs), Federally Qualified Health Centers (FQHCs) or clinically integrated networks, and must be licensed in the State of Delaware. Bidders may apply for multiple projects. The Health Care 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. Applications are due no later than Aug. 30.

“These one-time mini-grants offer a great opportunity for health care providers in Delaware to conduct pilot projects 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. “To embrace this change, we urge providers to test out collaborations or partnerships in the areas of data integration, care coordination or readiness to integrate into an ACO or an Alternative Payment Method.”

“In our continuing work with the State Innovation Model, the Health Care Commission has embraced innovative ways to help practices succeed in the changing health care delivery environment,” said Dr. Nancy Fan, Chair of the Delaware Health Care Commission. “These mini-grants, along with the ongoing work through our practice transformation vendors, give us practical ways to help facilitate that change.”

Applications must be made in 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, supporting innovative changes in the way health care is delivered and paid for in order to drive quality and better health for all in our state,” said Julane Miller-Armbrister, executive director of DCHI. “We encourage Delaware health care providers to apply for these mini-grants as a way to pilot their ideas for comprehensive reform.”

Applications will be evaluated and considered as they are received, with the final notifications of award coming by Sept. 30. For potential applicants, the Health Care Commission will host a Q&A session via conference call at 2 p.m. Aug. 9. Please email DHCC@delaware.gov for call-in information. All questions and final applications also must be submitted by email to DHCC@delaware.gov.


Governor Carney Signs Executive Order on Health Care Spending

Advisory group will advance health care benchmark initiative to reduce costs, improve outcomes

WILMINGTON, Del. – Taking the next step in implementing a health care spending benchmark for Delaware, Governor John Carney has signed an executive order establishing the Health Care Delivery and Cost Advisory Group to provide feedback to the Secretary of the Department of Health and Social Services (DHSS) on how to measure and report the total cost of health care in Delaware and how to determine metrics across the health care system to create quality benchmarks.

The creation of the advisory group to implement the spending benchmark comes five months after the Governor signed House Joint Resolution 7 granting authority to DHSS to establish a benchmark with a growth rate for health care spending linked to the overall economy of the state. In June, the Centers for Medicare and Medicaid Services (CMS) released a 50-state analysis of per-capita health care spending showing Delaware had the third-highest rate in 2014 behind only Alaska and Massachusetts.

The CMS analysis of all insurance payers – Medicare, Medicaid and commercial – found that Delaware’s per-capita rate was $10,254, or more than 27 percent above the U.S. average of $8,045. Without changes, the analysis estimates that Delaware’s total health care spending will more than double from $9.5 billion in 2014 to $21.5 billion in 2025.

“Delaware has consistently ranked among the states that spend the most on health care, yet we’re not seeing the best results,” said Governor Carney. “High costs present a barrier to quality health care, squeeze family budgets, crowd out other important state investments, and prevent businesses from investing in innovation and job creation. We’re committed to addressing this issue, to bringing providers to the table, reducing costs, and improving health outcomes for Delawareans across our state.”

“We have the talent and the capacity in our Delaware health care community to move to better value in our health care system and deliver better outcomes for the people of our state,” said DHSS Secretary Dr. Kara Odom Walker, a board-certified family physician. “The advisory group gives us the unique opportunity to continue progress in a collaborative forum and gather input on how to best to track the trend lines in the total cost of health care over time.”

The advisory group will provide feedback to the DHSS Secretary on the selection of methodologies to measure and report on the total cost of health care in Delaware, and on the establishment of a spending growth target that will become Delaware’s cost benchmark. Advisory group members also will help identify which metrics should be used to create quality benchmarks across our healthcare system to reduce costs, and recommend changes to the Delaware Health Care Commission.

The advisory group will include the DHSS Secretary; Director of the Office of Management and Budget; Chair of the Delaware Health Care Commission; Chair of the Delaware Center for Health Innovation; hospital representatives; representatives from the insurance industry, a licensed physician; a health economist; and a business community representative.

A full list of members is available in the text of the Executive Order. The advisory group will dissolve on June 30, unless the period is extended.

Click here to watch a video message from Dr. Kara Odom Walker, Secretary of the Delaware Department of Health and Social Services, on the benchmark initiative.

To learn more about the health care spending benchmark, visit:
https://www.choosehealthde.com/Health-Care-Spending-Benchmark

 

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