Brian Frazee is the president and CEO of the Delaware Healthcare Association. This statement was issued following the May 13 meeting of the Diamond State Hospital Cost Review Board.
Delaware is facing millions of dollars in funding cuts to vital health programs and resources. This means that health access and outcomes for thousands of people are literally on the line. As federal negotiators put pen to paper, the likelihood of deep cuts to Medicaid and other health care programs will likely mean more uninsured patients in Delaware, less people seeking preventive care, worsening health conditions and more residents relying on emergency rooms for all their health care needs. The recent closure of Crozer Health in nearby Pennsylvania is also putting additional pressure on our nonprofit hospitals. Those facilities will continue to care for every person who enters their doors, 24/7/365, regardless of his or her ability to pay, but federal cuts and more uninsured individuals mean lower reimbursement for hospital providers, straining critical resources.
Implementation of House Bill 350 continues, without regard for the uncertain realities our hospitals are facing daily, and there is a pending lawsuit that questions the very validity of the law. Additionally, Delaware’s hospital control board is now estimated to cost more than double the original estimates. When we are bracing for federal cuts to Medicaid and other health programs, now is not the time to be wasting $2.5 million in taxpayer funds on a model that has failed in Vermont.
The disastrous consequences of states controlling hospital budgets are playing out in real time in Vermont, which was the model for the HB 350 law. Vermont has the highest health insurance premium costs in the country and some of the highest health care costs in the nation. Most of Vermont’s hospitals are operating at losses, cutting jobs and services, and several are on the verge of closing. No other state in the country is looking to it for advice on health care policy for these reasons. In a recent interview, Vermont’s top health care regulator said it is “in a crisis situation.” We can and should do better in Delaware, especially given our uniquely growing and aging population.
Delaware recently moved up the ranks to No. 1 in hospital quality, according to U.S. News & World Report. We cannot continue to follow a failed model when there is clearly a better way. The Delaware Healthcare Association and its members believe that transparency and accountability in health care will lead to affordability solutions, but this is not the right approach to build a better system for all of us. The facts are clear: The law authorizes a state-run board to ask a hospital for its entire budget and strategic plans. It has not been determined how hospitals will be held individually accountable to a health care spending benchmark (which includes factors outside of their control), but if they do exceed the benchmark, the board can place them on performance improvement plans. The board has the authority to step into a hospital’s private governance and take over its budget if it’s not satisfied with the PIP process. Hospitals are the only health care sector impacted by this law.
We need a collaborative approach to ensure quality, accessible, equitable and affordable care for our patients and communities. DHA is committed to working with state leaders and legislators on solutions that make sense for not only the current climate but for the future.
Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.
