NEW CASTLE (April 6, 2023) – Department of Health and Social Services (DHSS) Secretary Molly Magarik presented the State’s third 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 2021 data against a set benchmark, as well as baseline data from 2019 and 2020. 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. This Benchmarking program was codified in August of 2023 through House Amendment 1 for House Bill 442.

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%, which was met as the Total Health Care Expenditures (THCE) per-capita change from the prior year was estimated at -1.2%. Delaware’s spending benchmark is the year-over-year percentage change in total health care expenditures (THCE) expressed on a per capita basis.

For Calendar Year 2021, the spending benchmark was set at a 3.25 percent growth rate. Delaware’s total Calendar Year 2021 THCE was approximately $9.1 billion. The per capita amount was $9,088, which represents a 11.2% year-over-year increase.

The 11.2% per capita increase is significant, but this figure reflects Delaware’s health care market rebounding from the reduction in health care spending and utilization in Calendar Year 2020 caused by the COVID-19 pandemic.

    “While the increase in per capita health care spending is significant, it was not surprising as this figure reflects Delaware’s health care market rebounding from the reduction in health care spending and utilization in 2020 caused by the COVID-19 pandemic,” said Secretary Magarik. “We know many Delawareans delayed preventive health care services or procedures at the height of the pandemic in 2020. As individuals started to return to schedule those services in 2021, we anticipated that the spending growth would increase as well. While we must continue to view these data in context of the extraordinary circumstances faced during the

pandemic, the benchmark will continue to be a valuable tool in comparing health care spending year over year, and driving targeting initiatives to improve health care delivery.”

The 2021 Trend Report also provides insight into Delaware’s health care quality by presenting data on six quality measures.

The quality results for 2021 were similar to 2020. 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. For the 2021 Trend Report, additional quality data stratifications and demographic information related to age, gender, and race/ethnicity were requested from the carriers. The request for additional stratifications came from Commissioner feedback during last year’s Trend Report presentation and has since been incorporated into the process and will continue to be shared as data is available. It is the hope of the Commission that this additional data will help provide more insight in health disparities and improve health equity throughout the State.
Overview of Quality Results

    Adult obesity: The benchmark for 2021 was to reduce the percentage of Delaware adults who are obese to 28.7%. The 2021 result: 33.9%; a decrease from 2020, but still 5.2 percentage points higher than the benchmark.

    Use of opioids at high dosages: The 2021 benchmark: 11.6%; the 2021 result: 9.6%. This is a positive observation.

    Opioid-related overdose deaths: The benchmark for 2021 was to reduce the mortality rate to 14.7 deaths per 100,000. The 2021 result: 48.1 deaths per 100,000. This is an increase from 2020.

    Emergency department utilization: The benchmark for 2021 was to reduce Emergency department utilization to 178 visits per 1,000. The 2021 result: 163 visits per 1,000. This is a positive observation.

    Persistence of beta-blocker treatment after a heart attack: The benchmark rate for 2021 was to increase the percentage of patients who receive beta-blocker treatment to 87.2% of commercial insurance patients and to 83.1% for Medicaid patients. The 2021 results: 88.5% for commercial insurance patients and 80.7% for Medicaid patients. While the Medicaid patients did not reach the benchmark, this is an improvement from the 2020 results of 78.1%.

    Statin therapy for patients with cardiovascular disease: The benchmark rate for 2021 was to increase the percentage of patients who receive statin therapy to 81.0% of commercial insurance patients and 63.8% for Medicaid patients. The 2021 results: 81.8% for commercial insurance patients; 66.1% for Medicaid patients. For both markets, results were better than the respective benchmark.