House Passes Bill to Strengthen Primary Care

All Senate Republicans voted not to improve your primary healthcare back in May, and for reasons passing all human understanding, Democrat Trey Paradee joined them. One defection on improving our primary healthcare system in Delaware was surprising, but we survived. But then the bill went to the House.

The Fearful Four of House Democrats (Andria Bennett, Bill Bush, Bill Carson and Pete Schwartzkopf) also voted no, and it makes absolutely no sense, especially when you consider that 3 “moderate” Republicans (Kevin Hensley, Michael Smith, and Mike Ramone) voted yes. Am I to conclude that those three Republicans have more principle and courage than the Fearful Four plus Paradee? I guess I have to.

Senate Bill 120(S) would implement a series of reforms designed to improve the metrics used to reimburse providers, place hard caps on total cost increases of certain inpatient and outpatient medical services, bolster investments in expanding the availability of primary care services and provide the Department of Insurance tools to address ballooning costs. 

The proposed reforms were informed by the work of the Delaware Department of Insurance and its Office of Value-Based Health Care Delivery, which was created by the General Assembly in 2019. Those agencies also would be tasked with implementing the legislation, creating necessary regulations, and enforcing its measures. 

The substitute bill adds a sunset provision that would require the General Assembly to renew aspects of the legislation by January 1, 2027, allowing for re-evaluation of whether the rate caps and alternative payment models proposed by the bill are working to control health care costs and expand primary care options in Delaware. 

Senate Bill 120(S)  Sponsors	Yes Votes	No Votes
Townsend, Ennis, Gay, Lockman, S.McBride, Sokola, Sturgeon	Passed Senate 13-7-1. Brown, Ennis, Gay, Hansen, Lockman, Mantzavinos, Pinkney, Poore, S.McBride, Sokola, Sturgeon, Townsend, Walsh	Bonini, Hocker (not voting), Lawson, Lopez, Paradee, Pettyjohn, RIchardson, Wilson
Bentz, Baumbach, Brady, Griffith, Heffernan, K.Johnson, Kowalko, Lynn, Osienski, K.Williams, Wilson-Anton	House Passed 24-16-1. Baumbach Bentz Bolden Brady Chukwuocha Cooke Dorsey-Walker Griffith Heffernan Hensley K.Johnson K.Williams Kowalko Lambert Longhurst Matthews Minor-Brown Mitchell M.Smith Morrison Osienski Ramone S.Moore Wilson-Anton	Bennett, Briggs King, Bush, Carson, Collins D.Short Dukes Gray Morris Postles Shupe Smyk Spiegelman Vanderwende Yearick, Lynn (absent), Schwartzkopf
Current Status:	Sent to Govenror.

SB 120(S) received an endorsement from ChristianaCare, the largest health system and the largest private employer in the First State. 

“ChristianaCare has invested heavily in expanding access to high-quality primary care services in the State of Delaware, and we remain deeply committed to identifying opportunities to provide additional resources, support and partnership to independent primary care physicians in the community in their transition to value-based care,” Dr. Christine Donohue-Henry, ChristianaCare’s chief population health officer, said in a letter of support. “With this commitment in mind, we are supportive of the targets in this legislation for increasing investments in primary care services and incentivizing participation in meaningful alternative payment models.” 

ChristianaCare, which operates three hospitals and an extensive network of primary care and patient services, recently entered into a joint venture with Highmark Health, one of the region’s largest health insurance providers, to create a new model of value-based care that aims to incentive outcomes and efficiency. 

“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,” said Rep. David Bentz, the lead House sponsor of SS1 for SB 120. “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 ensuring access to it. This legislation will accomplish that goal and work to reverse the losses we’ve seen in recent years.”  

“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 toward success. This road map 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,” Insurance Commissioner Trinidad Navarro said. “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.”