On April 21, 2021, the Delaware General Assembly released Senate Bill 120 for consideration. The Bill’s sponsors, Senator Bryan Townsend and Representative David Bentz, seek to improve primary care access for Delaware residents.[i] The legislation was amended on May 17 to add a sunset provision requiring legislative renewal of aspects of the legislation on or before January 1, 2027, based on whether the proposed rate caps and payment models are working as intended to expand primary care access while controlling costs.
The legislation aims to improve Delaware primary care as follows:
1. Directing the State’s Health Care Commission to maintain compliance with value‑based care delivery models while developing and monitoring compliance with alternative payment methods;
2. Requiring health insurance carriers to spend certain percentages of their total costs on primary care;
3. Requiring the Office of Value‑Based Health Care Delivery to annually assess whether primary care spending is increasing in compliance with established mandatory levels;
4. Requiring the Office of Value‑Based Health Care Delivery to collect data, draft reports, and assess the percentage of spending for primary care delegated to hospitals for care coordination through alternative payment models; and
5. Removing the sunset date on provisions requiring various insurance plans to reimburse primary care physicians and other specified clinicians for primary care at no less than physician Medicare rates.[iii]
Senator Townsend emphasized:
“I am confident the legislation Representative Bentz and I put forward after three years of careful study and consideration will result in more primary care providers serving our communities and better health outcomes for our neighbors while also putting the brakes on the exorbitant increases in health care costs that we’ve all felt over the last decade or more. But I also recognize that transitioning to a new payment model may bring a level of uncertainty for some health care providers, who requested a reasonable opportunity to revisit these reforms after five years. The sunset provision and other changes included in the substitute bill reflect our willingness to work with Delaware health care providers who share our interest in providing the best possible health care system for the residents of this state.”[iv]
Representative Bentz, who chairs the Delaware House Health & Human Development Committee, noted there exists an urgent need to pass the legislation this year:
“The primary care industry in Delaware is facing substantial challenges. Physicians are retiring or leaving the state, creating a shortage that means poor access to care for residents. Factor in the low levels of investment and we have an unsustainable system. We need to tackle this crisis head‑on immediately. Primary care is critical to improving health outcomes and reducing costs long term. Everyone in health care recognizes the importance of primary care and insuring access to it. This legislation will accomplish that goal and work to reverse the losses we’ve seen in recent years.”[v]
Last month the Delaware State Senate passed the bill by a 13‑7 vote, and it will now be considered by the State House where it is expected to be approved for Governor Carney’s signature.
Delaware Insurance Commissioner, Trinidad Navarro, recently stated:
“In the years since the General Assembly began their primary care reform efforts, the Delaware Department of Insurance stood up the Office of Value‑Based Health Care Delivery, convened experts, and engaged stakeholders to outline a path towards success. This roadmap aimed to ensure that residents have access to high‑quality, affordable health care, and that the primary care provider community would be strengthened in the process. Through this legislation, the General Assembly is putting these plans into action, and we are proud to see this bill supported by so many key stakeholders. Together we will improve the physical, mental, and financial health of Delawareans.”[vi]
[i] “SB 120-Strengthening Primary Care-Passes Senate”, Blue Delaware, May 27, 2021.
[ii] “Legislation to improve Delaware health care amended”, Bay to Bay News, May 18, 2021.
[iii] Senate Substitute 1 for Senate Bill 120, 151st General Assembly, Original Synopsis.
[iv] “SB 120-Strengthening Primary Care-Passes Senate”, Blue Delaware, May 27, 2021.
[v] “SB 120-Strengthening Primary Care-Passes Senate”, Blue Delaware, May 27, 2021.
[vi] “SB 120-Strengthening Primary Care-Passes Senate”, Blue Delaware, May 27, 2021.