Research Reports | Market Access
February 2023

Delaware | 2023 | Health Plan Analysis (Event Driven)

Delaware is one of the smallest states in the Union both in terms of geography and population, but it is one of the most densely populated states and has been a ready adopter of healthcare reform. The state's health insurance exchange, Choose Health Delaware, featured just one carrier, Highmark, in 2022, however, in 2023, Aetna and AmeriHealth are entering the exchange marketplace. Delaware is in the process of implementing a model that will move the healthcare industry away from fee-for-service and focus on quality care and population health management. To that end, the state set targets each year and has kept it at 3.25 percent per capita healthcare spending growth for 2021 and three percent for the 2022 and 2023 calendar year, with the goal of ultimately getting expenditures lowered on a consistent basis. In addition, the state announced a series of value-based payment reform grants to providers to facilitate data integration and improve coordination through alternative payment models. The state is in the midst of a major overhaul of its Medicaid program, with the goal of an increased focus on quality care. Accordingly, the state launched its first four Medicaid ACOs, which will be effective from 2022 through 2024. Medicare Advantage has traditionally not been a strong sector in Delaware, but with the introduction of two new plans by Highmark, enrollment could see some shake-ups.

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