Delaware executive order aims to limit health care costs

As states around the country search for ways to rein in health care costs, Delaware Gov. John Carney has signed an executive order designed to help the state limit spending growth.

Delaware’s population ranks among the oldest in the nation, with more than 16 percent of residents 65 or older. As the population ages, the share of the state budget funding health care costs is rapidly increasing. The state spends $1.6 billion on employee health care and Medicaid costs — 36 percent of the state’s $4.4 billion budget.

On Tuesday, Carney signed Executive Order 25 to establish targets to limit growth of health care spending.

“This might be the most important executive order that I’m going to sign as governor,” Carney said in his Wilmington office. “It will force or encourage health care providers and those in the system to look at ways they can be more efficient.”

The Delaware Economic and Financial Advisory Council will have a role in creating the targets. DEFAC currently meets several times a year to provide lawmakers with an estimate of state revenue that is used to craft the state budget. The group will now also set a benchmark to limit health care spending on an annual basis.

The order also calls for quality standards to improve outcomes for patients, including a reduction of emergency room visits from 190 visits per 1,000 residents next year to 178 ER trips per 1,000 residents by 2021.

“Making sure we’re focused on quality measures that are linked to increased expenditures, but also what is actionable and meaningful to the population,” said Delaware Health and Social Services Secretary Kara Odom Walker. “We know we need primary care providers to be at the base of anything you do to move to value and improve outcomes, to think about prevention before you think about illness.”

By the end of January, Walker will produce a manual for how the state will achieve the goals of limiting costs and improving health outcomes.