State lawmakers passed legislation meant to address Delaware’s dearth of primary care providers.
Among other things, the measure requires insurance carriers to spend a certain percentage of their total cost on primary care. It also limits price increases for hospitals and it gives the Delaware Healthcare Commission oversight powers to make sure payers and providers are using value-based payment models.
The billis based on recommendations from the Delaware Department of Insurance (DOI).
“We think this is a solution that will steer the ship in a way that will help people with their healthcare outcomes, while increasing spend in primary care while not raising premiums,” said state Insurance Commissioner Trinidad Navarro.
Navarro says he’s hopeful it will help retain primary care providers and attract new ones to the First State.
“You have specialty care, you have surgeons and hospitals themselves have seen an increase in their costs over time, whereas primary care has really fallen behind,” he said. “This is going to allow primary care to see more dollars while others are taking a haircut.”
That haircut is raising some concerns among payers. In a statement, Highmark Blue Cross Blue Shield Delaware president Nick Moriello said the bill "causes concern around health care costs, an impact we expect to see in the near term. " He added Highmark is committed to continued collaboration with the DOI and working alongside primary care providers.
Primary care spending in Delaware is less than the national average and about half that of leading states, according to the state Office of Value-Based Health Care Delivery.
Both Kent and Sussex Counties are federally designated shortage areas for primary care.
An approximate 815 primary care physicians were counted as practicing in the First State in 2018 with 662 working full-time. That’s a 10% drop from 2008, according to a state-run study, and survey data indicates the downward trend will likely continue.
Navarro says more regulatory work is required from his department after the bill becomes law.
The bill passed 13 to seven in the Senate and then 24 to 16 in the House with both support and opposition from Republicans and Democrats alike. It awaits Gov. Carney’s signature.
This story has been updated.
