In recent years, Delaware has acted to improve healthcare quality and bend the healthcare cost growth curve by:

• Implementing healthcare quality and spending benchmarks.
• Creating the Primary Care Reform Collaborative to make recommendations on payment reform, value-based care, workforce and recruitment, and primary care investment and access;
• Implementing a state reinsurance program under the federal 1332 waiver program to stabilize the health insurance marketplace
• Issuing regulations to increase the registration, oversight and transparency of pharmacy benefit managers and require corrective action as needed; and
• Lifting payment and other barriers to ensure that providers could easily transition to providing telemedicine services including phone-based visits during the COVID-19 pandemic.

To further help bend the healthcare cost growth curve, in 2019, Senate Bill 116 of the 150th Delaware General Assembly directed the DOI to create the Office of Value Based Health Care Delivery to “reduce health-care costs by increasing the availability of high quality, cost-efficient health insurance products with stable, predictable, and affordable rates.” SB 116 charged the Office with three tasks:

1. Establish Affordability Standards for health insurance premiums based on recommendations from the Primary Care Reform Collaborative and annually monitor and evaluate these standards;
2. Establish targets for carrier investment in primary care to support a robust system of primary care by January 1, 2025; and
3. Collect data and develop annual reports regarding carrier investments in health care, including commercial reimbursement rates for primary and chronic care services.

The Office met that objective by conducting extensive research on Delaware’s Healthcare Market. The results include six Key Findings and three Affordability Standards, all of which are included in a report on which the Department sought public comment. The Final report, “Delaware Health Care Affordability Standards: An Integrated Approach to Improve Access, Quality and Value”, public comments, and the Department’s responses to comments may be accessed below:

• Final Report
• Public Comments
• Department’s Response to Comments

In August 2018, the Delaware Legislature enacted Senate Bill 227 which requires Delaware health insurance carriers reimburse for primary care and chronic care management services at a rate that is not less than the Medicare reimbursement for comparable services. In its report, Delaware Primary Care Reimbursement: Evaluating Parity with Medicare Rates, the Office evaluates carrier compliance with statute and provides an analysis of commercial primary care spending reimbursement rates in Delaware.