DHSS Adds Prescription Drug and Imaging Procedures Cost Comparisons to CostAware Website

CostAware Compares Health Care Costs and Quality Based on Delaware Medical and Pharmacy Claims

NEW CASTLE (September 28, 2023) – The Delaware Department of Health and Social Services (DHSS) announced today enhancements to the CostAware website, designed to help Delawareans understand how their health care dollars are spent by comparing the variation of average costs for different episodes of care and medical services based on actual medical and pharmacy claims in Delaware.

The newest CostAware enhancements include cost comparisons for brand and generic prescription drugs by drug category and payer type (commercial insurance, Medicaid, Medicare Advantage). Also added in this update are average cost comparisons for imaging procedures (head CT, lumbar spine MRI, and screening mammography) by provider organization.

• Prescription Drug Costs compares the average daily cost of brand and generic drugs in Delaware by category and payer type based on 2021 pharmacy claims data. Prescription drugs are identified by National Drug Code (NDC) and grouped into categories assigned based on the condition the drug is intended to treat.
• Imaging by Provider Organization shows the average cost of imaging procedures by payer type, claim year and provider organization. Estimates reflect both the facility cost (taking the image) and professional cost (reading and interpreting the image).

“Delawareans can now compare costs for prescription drugs by drug category and imaging procedures by provider organization to help them make better decisions around their health care,” DHSS Secretary Josette Manning said. “CostAware has served as a valuable tool for Delawareans since its launch in April 2022. These additional data enhancements will bring another layer of transparency around the health care dollars being spent by Delawareans and their insurers.”

In addition to the prescription drug and imaging procedure cost reports, the most recent version of CostAware includes:

• Average cost estimates for episodes of care including C-section births, emergency department visits, knee and hip replacement, and vaginal delivery reported for Delaware hospitals.
• Estimates of the average cost per visit for medical services including child wellness visits, mental and behavioral health services, diabetes care, cardiac procedures, adult doctor visits, and lab tests (blood and urine tests).
• Results reported by care setting including hospital outpatient facility, outpatient lab, professional office, urgent care facility, and telehealth.
• Multiple years of data: Results are reported for 2019, 2020 and 2021.
• Filtering of results by insurance category (Commercial insurance, Medicaid, Medicare Advantage) and patient age range and gender (as appropriate).

The CostAware website was developed by DHSS and the Delaware Health Care Commission (DHCC) in collaboration with Delaware Health Information Network (DHIN).

In early 2020, DHSS and DHCC began working with DHIN to develop and implement various health care cost and quality analyses. These analyses leverage data in the Delaware Health Care Claims Database (HCCD), which was established through legislation passed by the General Assembly in 2016. DHIN manages the claims database and DHSS uses it to inform and support a variety of policy initiatives.

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Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.