DHSS Launches Website Comparing Costs for Select Episodes of Care and Services

NEW CASTLE, DE – The Department of Health and Social Services (DHSS) has launched a new website called CostAware 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 claims in Delaware.

Hospital costs are compared for five common episodes of care at six hospital systems: cardiac procedures, C-section birth, emergency department visits, knee and hip replacement, and vaginal delivery. The costs across five accountable care organizations (ACOs) are also compared for seven common services: blood count, colonoscopy, doctor visits, hemoglobin A1c, head CT, lumbar spine MRI and screening mammography. The rates are based on 2019 medical claims in the Delaware Health Care Claims Database and reflect the cost that consumers and their insurers actually paid for the care.

In addition, quality measures are provided, including the readmission and utilization rates, and patient satisfaction scores, all from the Centers for Medicare and Medicaid Services (CMS) as part of its Hospital Compare and Medicare Shared Savings Program initiatives. Each episode of care and service can be filtered further by the type of insurance: commercial, Medicare Advantage and Medicaid.

“This kind of transparency and public awareness of health care spending is important for everyone in the system – consumers, health care providers, taxpayers, insurers and businesses,” said DHSS Secretary Molly Magarik, who is also a member of the Delaware Health Care Commission. “We all want good value for the health care dollars we do spend. CostAware offers a glimpse into the actual costs that Delawareans and their insurers are paying, and the quality measures associated with that care.”

In this initial version of CostAware, the Delaware hospital systems and accountable care organizations are not identified. Secretary Magarik said she hopes to include that information in future versions of the website.

The site also breaks down the average monthly cost of care for each member of an accountable care organization and the top procedures for several age and gender groups based on overall volume and dollar volume.

In early 2020, DHSS and the Delaware Health Care Commission began working with Delaware Health Information Network (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.

CostAware is the result of goals from that partnership that include expanding the claims database analysis, measurement and reporting capabilities to increase transparency; highlighting variation in health care system performance; adding to consumers’ knowledge base; and identifying opportunities to improve quality and reduce costs for Delaware residents.

Early in his administration, Governor John Carney said one of the most important things he could do as Governor is to slow the growth of health care spending. In late 2018, the Governor signed Executive Order 25, establishing a state health care spending benchmark, a per-annum rate-of-growth benchmark for health care spending, and several health care quality measures. The first spending benchmark went into effect on Jan. 1, 2019, and was set at 3.8%, with the target expected to decrease gradually to 3% over the following three years. The first benchmark report measured the growth rate at 7.8% for 2019, or more than twice the 3.8% target.

The CostAware website was developed by DHSS and the Health Care Commission in collaboration with DHIN.

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