The Office of Value-Based Health Care Delivery delivers a report on progress made with insurance carriers and their compliance with affordability standards.
The Annual Review of Carrier Progress Towards Meeting Affordability Standards was issued last month, and it’s the first time this report has been issued.
The Office established the standards in 2021 and 2022, and collected data from insurance carriers about their projected compliance for this year - the first year of affordability standard implementation.
Cristine Vogel – director of the Office of Value-Based Health Care Delivery – explains one key finding from the report concerning carriers.
"All the carriers in Delaware are reporting that they will be in compliance. Compliance throughout the year,” said Vogel. “So for the year of 2023 there's requirements they need to meet, and they're on track to meet them."
They have to comply in three required service categories – inpatient hospital, outpatient hospital, and other medical.
The office says this will save Delawareans an estimated $2 to $12 million with the amount depending on price increases hospitals would have otherwise negotiated with carriers.
"The good news in the report is as long as all the health plans stay on track we'll be introducing $8 million more into our primary care system. Although the reports are based on compliance, some of the data that they provide to the office allows us to measure the percent of investment that they'll be spending on primary care versus other care services," said Vogel.
This year’s projections show carriers will increase their investment in primary care spending.
“The statutory charge of the Office is to “reduce health-care costs by increasing the availability of high quality, cost-efficient health insurance products with stable, predictable, and affordable rates,” said Insurance Commissioner Trinidad Navarro. “I am pleased that overall, carriers project compliance with the affordability standards set by the Office.”
The projections also show that on a per member per month basis primary care investment will increase to $29 this year for practices engaged in value-based care programs. It was $11 last year.
