Delaware Office of Management and Budget

The forum focused on payment reform within the Delaware healthcare system, addressing the challenges of unsustainable healthcare costs and the need to shift from volume-driven models to value-based care. Key discussions centered on the Triple Aim of lower costs, better care, and better health, highlighting the importance of stakeholder engagement and the integration of behavioral health. Participants reviewed successful strategies from other states, particularly Maryland's global hospital budget model, and discussed how to improve primary care and create medical homes for patients. The forum emphasized the role of data-driven approaches and the need for collaborative efforts between hospitals, providers, and state administration to address healthcare affordability and demographic changes.

The fifth summit focused on the healthcare benchmark, specifically discussing governance and authority structures from Vermont, Massachusetts, and Oregon. Key topics included the importance of independent versus representative boards for healthcare oversight, the challenges of implementing reform bills, and the shift toward coordinated care models. Discussions highlighted the impact of social determinants on health and the role of community health workers in preventing emergency room visits.

The meeting focused on the development of fiscal year 2022 recommendations, acknowledging anticipated budget reductions. A litigation update was provided concerning the tobacco settlement and statutory enforcement obligations, with an estimate provided for the upcoming annual payment. Additionally, a budget update was presented, covering the fiscal year 2021 financial package, revenue forecasts, and cost drivers such as rising Medicaid enrollment and growth in special education student units.

The committee held a discussion on funding scenarios for the health fund to address budget projections and ensure the sustainability of programs, including those related to tobacco prevention, cancer support, and nursing. Key topics included a proposal to switch-fund specific programs to the state's general fund to optimize the use of remaining tobacco funds and preserve the committee's reserve balance. The discussion also covered the impact of social determinants of health and the need for a strategic realignment of funding sources for critical services such as the nurse-family partnership and behavioral health programs.

The Committee discussed the funding shortfall for the upcoming fiscal year. Key topics included a review of different budget scenarios, the impact of dwindling tobacco funds on program support, and the necessity of aligning spending with statutory guidelines. Members debated the potential for switch-funding DHSS programs and explored how future funding might be managed, emphasizing the need for strategic collaboration with the legislature to maintain vital services despite a challenging financial environment.