Initiatives

The Strategic Seven will get us where we want to go.

We’ve identified seven goals to help improve the quality of care and reduce the cost of health care in Delaware. These goals set the blueprint for change that health care institutions and providers will be working to implement as we move forward.

  • Accelerate payment-reform readiness.

    We offered health care providers a short-term investment fund they could use to prepare for the new payment models. We’ve also engaged in value-based purchasing with Medicaid’s Managed Care Organizations.

    The provider investment fund is helping with data integration, in order to improve patient care coordination and help practices operate using an Alternative Payment Method. Also, to accelerate payment reform, in January 2018, Delaware entered into a value-based purchasing care initiative with its Medicaid Managed Care Program. In the three years that we’ve been working to address payment reform, we’ve identified seven key measures to monitor the transition of the system away from traditional fee-for-service, volume-based care. Our goal is to focus on rewarding and incentivizing improved patient outcomes, value, quality improvements, and reduced expenditures.

  • Establish cost and quality benchmarks.

    The benchmarks will help enhance transparency, monitor spending and outcomes, establish accountability for improving care, and slow the growth rate for health care costs.

    Culminating nearly a year of outreach, research, and deliberation in developing a strategy to address the unsustainable growth in health care spending in Delaware, Governor John Carney signed an executive order establishing health care spending and quality benchmarks. Delaware’s health care spending benchmark for 2019 through 2023 will be between 3 percent and 3.8 percent per-capita Potential Gross State Product (PGSP) growth rate.

  • Strengthen primary care.

    In Delaware, reimbursement for primary care services is below the national average. Work is underway to remedy that by requiring insurers to reimburse providers at a rate that is at least equal to Medicare rates. Efforts are also underway to bring more primary care providers into our state. Delaware has also agreed to participate in a national health-related program, with the goal of reducing obesity in the Medicaid population.

    The Primary Care Collaborative that has been formed in our state is set on improving access to and the capabilities of primary care providers. Delaware is also participating in a first-ever initiative that offers obesity prevention and treatment for individuals of all ages. With obesity and diabetes at epidemic rates in our state, My Healthy Weight offers a way to support healthy weight change, reduce statewide obesity rates, and give people a way to prevent and treat obesity.

  • Advance behavioral health integration.

    Mental health is part of overall health and wellness. Recognizing that, we are working to bring behavioral health evaluations and services into the primary care setting.

    Provider practices throughout the state are beginning to integrate behavioral health services into primary care. Dozens of practices have received technical assistance in the form of individual coaching, readiness assessments, knowledge-sharing opportunities, and more. And work is also underway to encourage payment incentives for incorporating behavioral health into primary care.

  • Establish a Health Care Claims Database.

    The key to understanding where we stand and how we are improving depends on data — the type of information that will be provided by a Health Care Claims Database. Senate Bill 236 provided funding for work to begin on establishing the database.

    The Delaware Health Information Network (DHIN) will build the database, with the understanding that additional support may be needed as work progresses. A Health Care Claims Database is the first step in creating transparency in cost and quality across all health systems and health care service providers.

  • Advance and shift Healthy Neighborhoods work to new entity.

    Community programs that have been working to provide health-related activities throughout the state have been guided by three local councils and funded by community partners. These types of programs will continue under Healthy Communities Delaware.

    Healthy Communities Delaware addresses health care needs through community funding and leadership. It is a partnership spearheaded by the State of Delaware, the University of Delaware and the Delaware Community Foundation, with the support of public, nonprofit and private organizations throughout the state.

  • Engage patients and consumers.

    We want to help people learn and care about what is happening and how it affects them and their daily lives. A revamped Consumer Advisory Committee invites Delawareans to get involved.

    We invite all Delawareans to learn about the changes we are making on the Road to Value at public meetings, by signing up for web updates and through social media posts.

Road To Value In Action

News Article
Delaware Receives Approval from Federal Government for 1332 Waiver to Establish Reinsurance Program Beginning in 2020
Delaware Receives Approval from Federal Government for 1332 Waiver to Establish Reinsurance Program Beginning in 2020

Posted: August 20, 2019

The Department of Health and Social Services received approval Aug. 20 from the Centers for Medicare and Medicaid Services for a 1332 State Innovation Waiver under the Affordable Care Act to create a reinsurance program beginning in 2020 as a way to reduce premiums by up to 20 percent in Delaware’s individual health insurance market. […]
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News Article
DHSS Receives Medicaid Substance Use Disorder Waiver from Federal Government
DHSS Receives Medicaid Substance Use Disorder Waiver from Federal Government

Posted: August 7, 2019

The Delaware Department of Health and Social Services received approval in late July from the Centers for Medicare and Medicaid Services for a waiver amendment allowing the department to use federal Medicaid funding for addiction-related treatment of individuals in facilities known as IMDs. The full article can be read here.
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News Article
Health Insurance Rates Decrease 5.8%
Health Insurance Rates Decrease 5.8%

Posted: July 1, 2019

July 1, 2019 Dover, DE—Highmark Blue Cross Blue Shield of Delaware (Highmark BCBS) has submitted its required annual rate filing to the Delaware Department of Insurance. After years of substantial increases, Delaware’s Marketplace has stabilized and premiums have decreased. Highmark BCBS, the only insurer continuing to offer insurance coverage in Delaware’s individual market, has proposed […]
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The path forward is filled with opportunities to make care better for all of us.

Change is necessary to improve how we deliver care and determine what we’re paying for it.

Dr. Kara Odom Walker, Cabinet Secretary, Delaware Department of Health and Social Services

Voices for change: “We are something like 30th in health care rankings, but we’re spending a lot for that care. We’re spending at a rate that puts us at third-highest per person in the United States.”