By Tim Mastro

NEW CASTLE — The state met its health care spending benchmark in 2020, but saw increases in adult obesity and opioid-related overdose deaths, according to the Department of Health and Social Services’ second annual Benchmark Trend Report, released earlier this month.

The report displays trends in Delaware’s health care spending and quality, comparing new 2020 data against a set benchmark, as well as baseline data from 2019. It is part of an effort to improve health care quality for all residents, while simultaneously working to monitor and reduce the economic burden of health care spending.

For adult obesity, the benchmark for 2020 was to reduce the percentage of Delaware adults who are obese to 29.4%. The 2020 result, however, was 36.5% — an increase from 2019 and 7.1 percentage points higher than the benchmark.

Meanwhile the opioid-related overdose deaths benchmark for 2020 was to reduce the mortality rate to 15.5 deaths per 100,000. The state ended up recording 43.9 deaths per 100,000 which was an increase from 2019.

The state did see progress in other quality measures.

A new benchmark for 2020 was the use of opioids at high dosages, using the Delaware Prescription Monitoring Program to observe the rate at which high-dose opioids were prescribed. The 2020 benchmark was 12.4% with the result of 11.1%, which DHSS noted was a positive observation.

For persistence of beta-blocker treatment after a heart attack, the benchmark rate for 2020 was to increase the percentage of patients who receive beta-blocker treatment to 84.9% of commercial insurance patients and to 80.1% for Medicaid patients. The state was successful for commercial insurance patients at 91.7%. While the Medicaid patients were at 78.1%, below the benchmark, it was an improvement from the 2019 result of 73.5%.

Finally, the benchmark rate for 2020 was to increase the percentage of patients who receive statin therapy to 80.5% of commercial insurance patients and 61.5% for Medicaid patients. Both results were better than the respective benchmark ­­­­— 83.6% for commercial insurance patients; 72.6% for Medicaid patients.

“Unfortunately, the results of the quality measures are mixed,” DHSS Secretary Molly Magarik said. “While Delaware made progress in some important measures, the report shows us there is still significant work to be done to improve the health of Delawareans in other areas. At DHSS, we look forward to working with health care providers, insurers, legislators, businesses, other government leaders and, most importantly, consumers to help build a healthier Delaware.”

Delaware’s first spending benchmark went into effect on Jan. 1, 2019, and was set at 3.8%. That spending benchmark was not met, as the finalized health care spending for 2019 grew at a rate of 5.8%.

For calendar year 2020, the spending benchmark was set at a more ambitious target of 3.5%. This benchmark was met, as the 2020 total health care expenditures per-capita change from the prior year was estimated at -1.2%. Total expenditures encompasses health care spending associated with Delaware residents from private and public sources.

Total health care expenditures increased by $39 million in calendar year 2020, totaling $8.1 billion. However, with Delaware’s population increasing by 1.7% from 2019 to 2020, the per-capita total decreased from $8,268 in 2019 to $8,173 in 2020.

“While the decreases in per-capita health care spending and the spending growth rate appear at first glance as a positive change, it is important to note that the COVID-19 pandemic had a significant impact on preventative health care services, health care facility utilization, service delivery and payer/provider finances,” Ms. Magarik said. “These benchmark findings need to be viewed in the context of the extraordinary circumstances we faced in 2020. And that makes equitable comparisons with previous calendar years extremely difficult.”