SPONSOR:

Sen. Townsend & Rep. Bentz

DELAWARE STATE SENATE

149th GENERAL ASSEMBLY

SENATE CONCURRENT RESOLUTION NO. 36

CREATING THE HEALTH CARE SPENDING TASK FORCE.

WHEREAS, health care costs continue to occupy a growing share of the State budget, as regards the cost of health care for state employees, retirees, and participants in the Medicaid program; and

WHEREAS, the State of Delaware increased spending on employee health insurance from $527.4 million to $708.1 million from fiscal year 2010 to fiscal year 2015; and

WHEREAS, the State has attempted to reduce employee health care costs through the DelaWELL Health Management Program and offering insurance plans with Health Reimbursement Accounts; and

WHEREAS, House Concurrent Resolution No. 81 from the 148 th General Assembly encouraged all state employees and state plan health plan participants to make good choices like being a wise health care consumer, choosing lower cost health care services, getting appropriate level of care, managing chronic diseases, and engaging in wellness and prevention; and

WHEREAS, the State of Delaware’s Statewide Benefits Office launched a comprehensive campaign in mid-March 2016 called “Being A Wise Health Care Consumer: What’s In It For Me?” to assist state employees and state health plan participants with understanding the power of their choices in making health care decisions to control and reduce insurance costs and improve their health and well-being; and

WHEREAS, social determinants, which are economic and social conditions that influence health, create health inequities and increase health problems and costs; and

WHEREAS, Medicaid costs continue to rise despite efforts to reduce Medicaid costs through the use of Medicaid waivers and state programs to support people in the community and at the lowest cost level of care; and

WHEREAS, Delawareans have come together to develop and implement a multi-stakeholder plan to improve health, ensure health care quality, and patient experience and reduce the growth rate in health care costs through a Centers for Medicare & Medicaid Services State Innovation Model grant;

WHEREAS, the Department of Health and Social Services, the Delaware Health Care Commission, the Delaware Health Information Network (“DHIN”), and numerous government and private sector stakeholders partnered to establish the Delaware Center for Health Innovation (“DHCI”) in 2014; and

WHEREAS, DHCI was formed to advance better health, improved quality, and a better patient experience, at a cost that is affordable and sustainable; and

WHEREAS, DHCI’s work has resulted in the development of a multi-payer scorecard to measure quality, improved alignment of quality measures among commercial and Medicaid payers, an increase in the adoption of value-based payment for primary care, and a population health strategy called the Healthy Neighborhoods Initiative which connects healthcare providers, patients, and community resources; and

WHEREAS, there is a need for State policy makers to continue to collaborate with other stakeholders to advance the goal of continuing to provide access to high-quality health care to all Delawareans, including State employees and Medicaid recipients, at a cost that is affordable and sustainable to the State, employers, and private payers; and

WHEREAS, State policy makers should evaluate proposed solutions to rising costs in State employee health care and Medicaid and rising premiums on the State’s Health Insurance Marketplace, in a manner that is reflective of the full picture of the State’s health care landscape; and

WHEREAS, more can be done to reduce health care costs and improve health outcomes for Delawareans.

NOW, THEREFORE:

BE IT RESOLVED by the Senate of the 149 th General Assembly of the State of Delaware, the House of Representatives concurring therein, that a Health Care Spending Task Force (“task force”) be created to produce comprehensive solutions for reducing the cost growth trend in the State’s health care spending while promoting and preserving access to high quality, affordable healthcare for all Delawareans.

BE IT FURTHER RESOLVED that this task force consist of the following members:

(1) The Chair of the Health, Children and Social Services Committee of the Senate.

(2) The Chair of the Health and Human Development Committee of the House of Representatives.

(3) One member of the Senate, appointed by the Senate Minority Leader.

(4) One member of the House, appointed by the House Minority Leader.

(5) The Secretary of the Department of Health and Social Services.

(6) The Secretary of the Office of Management and Budget.

(7) The Controller General.

(8) One member representing a large health care system or hospital, appointed by the Delaware Healthcare Association.

(9) One member representing a small health care system or hospital, appointed by the Delaware Healthcare Association.

(10) One member who is a health care provider in private practice, appointed by the Medical Society of Delaware.

(11) One member representing a health care facility, appointed by the Medical Society of Delaware.

(12) Two members, one appointed by the President Pro Tempore of the Senate and one appointed by the Speaker of the House of Representatives, from the following:

a. The President of the Delaware State Education Association, or the President’s designee.

b. The Executive Director of the American Federation of State, County, and Municipal Employees, or the Executive Director’s designee.

c. The President of the Correctional Officers’ Association of Delaware, or the President’s designee.

d. The President of the Delaware State Troopers Association, or the President’s designee.

(13) One member representing the insurance industry, appointed by the Governor.

BE IT FURTHER RESOLVED that this task force shall enlist the expertise of subject matter experts, including an independent health care economist, who are not currently under contract with State agencies, payers, or providers and are not seeking any such contractual arrangements.

BE IT FURTHER RESOLVED that this task force shall identify how to maintain continued support of the ongoing efforts to transition from fee-for-service to value-based payment models that drive improved outcomes.

BE IT FURTHER RESOLVED that this task force shall propose solutions based upon a data-driven approach using current and accurate data including accurate health outcome and cost trend data. Data should be reviewed by the independent health care economist for appropriate context and scope. Cost trend data should include all major sources of health care spending, including pharmaceutical costs.

BE IT FURTHER RESOLVED that this task force shall propose a State framework for addressing health care spending and access issues that includes and accounts for the challenges and investments in addressing Delaware’s “older and sicker” population and demographics that include a high rate of chronic conditions, a rapidly aging population, and disease burden exacerbated by social determinants of health including poverty, food insecurity, and violence.

BE IT FURTHER RESOLVED that this task force shall recommend ways to optimize transformation to a lower cost, value-based system where all parties participate in risk-sharing, including health systems, physicians, other providers, payers, and patients.

BE IT FURTHER RESOLVED that this task force shall propose solutions for cost growth trend reductions that are accompanied by proposals for responsible state Group Health Insurance Plan design changes.

BE IT FURTHER RESOLVED that this task force shall take into consideration the impact of proposed and enacted changes to federal law, including regulations, that may affect access to health care coverage and services for Delawareans.

BE IT FURTHER RESOLVED that this task force shall recommend ways to ensure access to affordable health care coverage for all Delawareans.

BE IT FURTHER RESOLVED that this task force shall propose solutions that reflect thoughtful consideration of whether other Medicaid waivers, alternative exchange models, accountable care organization models, or other models could more effectively advance the State’s long-term goals.

BE IT FURTHER RESOLVED that the Chair of the Health, Children and Social Services Committee of the Senate and the Chair of the Health and Human Development Committee of the House of Representatives are the co-chairs of this task force.

BE IT FURTHER RESOLVED that quorum of the task force shall be half plus one of its members.

BE IT FURTHER RESOLVED that the co-chairs of this task force are responsible for guiding the administration of the task force by, at a minimum, doing all of the following:

(1) Setting a date, time, and place for the initial organizational meeting.

(2) Supervising the preparation and distribution of meeting notices, agendas, minutes, correspondence, and reports of the Task Force.

(3) Sending to the President Pro Tempore of the Senate and the Speaker of the House of Representatives and to the Director of the Division of Research of Legislative Council, after the first meeting of the task force, a list of the members of the task force and the person who appointed them.

(4) Providing meeting notices, agendas, and minutes to the Director of the Division of Research of Legislative Council.

(5) Ensuring that the final report of the task force is submitted to the President Pro Tempore of the Senate and the Speaker of the House of Representatives, with copies to all members of the General Assembly; the Governor; the Director and the Librarian of the Division of Research of Legislative Council; and the Delaware Public Archives.

BE IT FURTHER RESOLVED that the task force shall hold its first meeting no later than September 30, 2017.

BE IT FURTHER RESOLVED that the General Assembly is responsible for providing reasonable and necessary support staff and materials for the task force to carry out its mission.

BE IT FURTHER RESOLVED that this task force shall compile a report containing actionable solutions to the issues assigned to it in lines 69 through 91 of this resolution and shall submit the report to all members of the General Assembly and the Governor no later than May 1, 2018.

SYNOPSIS

This Senate Concurrent Resolution creates a Health Care Spending Task Force be created to produce comprehensive solutions for reducing the cost growth trend in the State’s health care spending while promoting and preserving access to high quality, affordable healthcare for all Delawareans.

Author: Senator Townsend