GOV. CARNEY OP-ED: We Can Build on Health Care Progress

Governor John Carney published an op-ed about progress made in Delaware to get more Delawareans health insurance coverage, and reminds Delawareans the ACA health insurance marketplace enrollment period ends December 15. 

 

Ten years ago, before President Obama signed the Affordable Care Act into law, it was legal for insurance companies to deny Delawareans health coverage because they had diabetes or another pre-existing condition.

Across our state, more than 11 percent of Delawareans went without insurance. They skipped preventive visits to their doctors. And they accepted that a health crisis could also mean losing all their savings, or worse.

In the years since, we have made substantial progress in reducing the number of uninsured Delawareans.

With federal assistance, we have expanded our Medicaid program to provide quality health insurance coverage for Delaware families who need it the most. And more than 22,000 Delawareans have signed up for a health plan under the ACA health insurance marketplace.

Since implementation of the ACA, we have nearly cut our uninsured population in half in Delaware. And here’s some good news this year: rates on the ACA health insurance marketplace are down almost 20 percent, which we hope will encourage more Delawareans to get covered.

This is because, working with the General Assembly, we passed House Bill 193 into law, creating a reinsurance program which helped drive down the cost of coverage on the ACA marketplace.

In addition, some people will qualify for premium assistance, making the plans even more affordable.

That’s a really big deal. And as we near this year’s deadline of open enrollment on the ACA health insurance marketplace, we want to make sure even more Delawareans get covered.

For Delawareans who don’t have coverage through their employers, and for those who already have insurance through the ACA marketplace, I want to remind you and urge you to shop and compare ACA marketplace plans.

If you don’t have coverage, you need to act quickly. Enrollment on the ACA marketplace is open through December 15. Visit ChooseHealthDE.com to review your options and enroll at healthcare.gov.

If you’re not sure if can afford coverage on the marketplace, Westside Family Healthcare has health care navigators to help walk you through your options, including whether you and your family are eligible for financial assistance.

To make an appointment with a marketplace navigator, call Westside Family Healthcare at 302-472-8655 in New Castle County or 302-678-2205 in Kent and Sussex counties. Or visit ChooseHealthDE.com.

We know that we still have a lot of hard work to make health care more affordable for Delawareans and Delaware families. That’s why – working with members of the General Assembly – we created the new reinsurance program.

And that’s why we are working with health care providers on an initiative to bring transparency to health care prices and give Delaware consumers more information when they are making decision on where to get care.

Our overall goals are to reduce health care costs costs, and improve affordability and health outcomes for Delawareans across our state.

Our overall goals are to reduce health care costs and to improve affordability and health outcomes for Delawareans across our state. To do this, we need to build on the foundation of the ACA until all Delawareans are able to get the quality health care they deserve.

John Carney is the 74th Governor of the State of Delaware.


Delaware Issues RFP for Office of Value-Based Health Care Delivery

Delaware’s Department of Insurance is pleased to announce that it is actively recruiting for a qualified independent contractor to staff and run its new Office of Value-Based Health Care Delivery. The Office will assist the Insurance Commissioner and Delaware’s Primary Care Reform Collaborative in evaluating primary care accessibility and affordability statewide.

“Reducing health care costs in Delaware is a key priority of my administration,” said Insurance Commissioner Trinidad Navarro. “The team leading our Office of Value-Based Health Care Delivery needs to possess a high level of expertise in health care transformation and innovation. Together with the Primary Care Reform Collaborative, we intend to identify quantitative tools that will help increase the availability of high quality, cost-efficient health insurance products that have stable, predictable, and affordable rates.”

Earlier this year, members of the General Assembly passed Senate Substitute 1 for Senate Bill No. 116, in order to create the Office. The Office was a recommendation of the Primary Care Reform Collaborative, which is tasked with evaluating the high costs of care in Delaware. In the months since passage, the Collaborative has been working hard to develop recommendations to strengthen Delaware’s primary care system.

“The legislature’s consideration of pro-consumer bills has allowed us to continue to foster an environment where residents are prioritized over profits,” said Leslie W. Ledogar, Esq, the Commissioner’s representative within the working group. “The Office of Value-Based Health Care Delivery epitomizes that vision, and we are grateful for everyone who spent time working on this effort.”

The Request for Proposal may be downloaded from the Office of Management and Budget website. Applicant questions should be directed to the Department’s Regulatory Specialist Leslie W. Ledogar, Esq.


Secretary Walker Announces Appointment of New Director to Lead DHSS’ Division of Health Care Quality

NEW CASTLE (Sept. 3, 2019) – Department of Health and Social Services (DHSS) Secretary Dr. Kara Walker announced the appointment of Yrene Waldron, former Executive Director of the Delaware Health Care Facilities Association, to lead the Division of Health Care Quality. She will begin her duties Sept. 16.

“I am thrilled that Yrene is joining our Department as director of the Division of Health Care Quality,” Secretary Walker said. “As the former director of the Delaware Health Care Facilities Association, she brings extensive experience working with health care system and their staffs to her new role. She understands how the health care system works, the important role it plays in caring for and keeping Delawareans safe, and the role our Division of Health Care Quality which promotes quality care and the enforcement of state and federal laws and regulations.”

The Division of Health Care Quality, one of 11 divisions in the Department of Health and Social Services, has 72 full-time equivalent employees and an annual budget of $6.2 million for Fiscal Year 2020. The division’s mission is to protect patients and residents in health care agencies and facilities across the state. DHCQ staff licenses and certifies a broad range of facilities, homes and agencies, including nursing homes, hospitals, free-standing emergency departments, skilled home health agencies, office-based surgery facilities and group homes for individuals with mental illness.

The division also maintains an Adult Abuse Registry, a Criminal Background Check System for people who work in health care facilities and for agencies, a Certified Nursing Assistant (CNA) Registry, a Complaint and Incident Reporting System, and other enforcement systems.

“I am sincerely grateful and humbled by the opportunity to serve as the Director of Health Care Quality Division and look forward to working with stakeholders across the health care continuum on our mutual goals of improving health care quality outcomes,” said Yrene Waldron.

Waldron worked in the acute care setting prior to serving as the Executive Director of the Delaware Health Care Facilities Association from 1998 until this year, when she retired. She was responsible for monitoring, reviewing and analyzing federal and state statutes and regulations, and communicating changes to her members; coordinating educational seminars; and representing the organization on boards and commissions in Delaware and nationally. Among her achievements was establishing meaningful and trusting relationships with state and federal legislators, the governor’s administration, state agencies and other related stakeholders in order to reach consensus on outcomes affecting health care facilities.

Before being named to her position at the Delaware Health Care Facilities Association, Waldron held various positions with health care facilities and hospitals in Delaware, Florida and Pennsylvania.

Waldron succeeds Mary Peterson, who retired in April.


ICYMI: Governor Carney Signs Legislation Protecting Health Care for Delawareans

New laws codify ACA consumer protections in Delaware law and provide dental coverage for Medicaid recipients

WILMINGTON, Del. –  At Westside Family Healthcare, Governor John Carney joined members of the General Assembly and health care advocates to sign Senate Bill 35 and Senate Substitute 1 for Senate Bill 92, two pieces of legislation that will protect quality health care coverage for Delawareans and Delaware families.  

Senate Bill 35 codifies consumer protections of the Affordable Care Act in Delaware law – including protections for Delawareans with pre-existing conditions, the guaranteed availability of coverage, and permissible rating factors. Senate Substitute 1 for Senate Bill 92 will provide dental coverage for all eligible adult Medicaid recipients.

“All Delawareans and Delaware families deserve access to quality, affordable health care,” said Governor Carney. “Both of these pieces of legislation will help us deliver on that promise. Senate Bill 35 will codify in Delaware law many of the protections in the Affordable Care Act – including protections for Delawareans with pre-existing medical conditions. And adults on Medicaid will finally have access to affordable dental coverage, which we know is important to overall health. Thank you to Senator Paradee, Senator Townsend, and all members of the General Assembly for their partnership on this important issue.”

“Ensuring that Medicaid patients can access primary dental care touches on so much of what we are here to do,” said Senate Majority Whip Bryan Townsend. “It improves health care access for working families, makes our entire health care system more affordable and efficient by expanding preventative and primary care options, and upholds human dignity in a small but incredibly impactful way. I am thankful for the persistent, people-first leadership of our local health care advocates, doctors, and experts and I thank my colleagues in the House and Senate for making sure Delaware finally takes this critical step.”

“Quality, affordable health care – particularly protections for people with pre-existing conditions – should be available to every Delaware resident, not a political football to be yanked out from under them when they need it most,” said Representative Bill Bush. “By codifying key parts of the ACA, we are protecting this right for Delawareans for years to come, regardless of what happens in Washington.”

“Ensuring that Delawareans continue to receive the vital health care they need and deserve is paramount to my mission as Insurance Commissioner,” said Delaware Insurance Commissioner Trinidad Navarro. “Under this bill, Delaware guarantees that the most vulnerable consumers will continue to receive coverage. I thank Representative Bush and Senator Paradee for their commitment to protecting Delaware consumers.”

Photos from the signing ceremony can be found here.

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Delaware Sets Health Care Spending Benchmark

Benchmark initiative will limit spending growth, improve quality of care

NEW CASTLE, Del. – The Delaware Economic and Financial Advisory Council (DEFAC) on Wednesday issued a recommended Benchmark Index that set the state’s health care spending growth target at 3.8 percent for 2019 – the initial year of Delaware’s newly created Health Care Spending Benchmark. This move furthers the state’s goals of managing the growth of future health care spending, increasing transparency into how health care is delivered and paid for, and improving the quality and cost of health care for the citizens of Delaware.

DEFAC set the target based on Executive Order 25 signed by Governor John Carney in November. The order called for the initial benchmark to be equivalent to the advisory Benchmark Index for overall State budget growth established under Executive Order 21 signed by the Governor in June 2018.

“We know that the rising cost of health care crowds out other important state investments, keeps companies from hiring, and makes it harder for families to manage their household budgets,” said Governor Carney. “This benchmark initiative is about providing Delawareans with more transparency around their own health care spending, and making sure that Delawareans are getting the quality of health care that they’re paying for. At the state level, Delaware taxpayers rightly expect us manage their money wisely. This initiative will help us do just that.”

“Establishing the health care spending benchmark is an important step forward in learning more about how health care dollars are spent in our state,” said Dr. Kara Walker, Secretary of the Delaware Department of Health and Social Services. “In order to meet the current and future health care needs of Delawareans, our system of providing and paying for care has to change in order to be sustainable. We look forward to working with health care providers, insurers, businesses and consumers as we move forward in improving the patient and provider experience, while improving the overall health of Delawareans and doing it at a lower cost.”

“Establishing the Health Care Spending Benchmark is a vital step in establishing realistic economic measures that provide meaningful insight toward producing optimal outcomes with the limited health care dollars available to the state, our citizens and the private sector,” said Rick Geisenberger, Secretary of the Delaware Department of Finance.

In subsequent years, Executive Order 25 requires the health care spending benchmark to be calculated based on long-term projections for growth in Potential Gross State Product (PGSP). Currently, long-term PGSP is forecast at 3 percent. The target approved today provides a transitional market adjustment with the benchmark starting at 3.8% and then gradually expected to decline to 3% over the next three years.

A Health Care Spending Benchmark Subcommittee of DEFAC will monitor PGSP forecasts and health care spending trends and make annual recommendations for the Benchmark in future years.

The path to creating the health care spending benchmark began in the summer of 2017, when the General Assembly passed House Joint Resolution (HJR) 7 authorizing the Department of Health and Social Services (DHSS) to develop a spending benchmark. The Governor signed HJR 7 in September 2017, just months after an analysis by the Centers for Medicare and Medicaid Services (CMS) indicated that Delaware had the third-highest per-capita health care spending rate in the country, and a rate that was 27 percent above the U.S. average.

That fall, DHSS and Secretary Dr. Kara Odom Walker, a board-certified family physician, began a series of summits to explore how a spending benchmark could work for Delaware. In February 2018, Governor Carney signed Executive Order 19 creating an Advisory Group to provide feedback to Secretary Walker on the health care spending and quality benchmarks. While the overall health of Delawareans has been improving – Delaware is now ranked 30th among the states, according to America’s Health Rankings ¬– the pace of that improvement is trailing the growth of health care spending in the state.

Delaware has historically ranked among the top 10 states in per-capita health care spending, including in 2014, when the state ranked behind only Alaska and Massachusetts. The 50-state analysis by the Centers for Medicare and Medicaid Services (CMS) released in 2017 found that Delaware’s per-capita rate was $10,254. Without changes, the analysis estimated that Delaware’s total health care spending would more than double from $9.5 billion in 2014 to $21.5 billion in 2025.

Click here to learn more about the health care spending benchmark.

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