Healthcare News

Delaware Names First Director of Value-Based Healthcare Delivery

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The Delaware Department of Insurance has named Cristine Vogel its first director of value-based healthcare delivery.

Leading the Office of Value-Based Health Care Delivery, Vogel will establish, implement, and monitor affordability standards such as those to increase primary care investment, and manage the reporting of carrier investments in healthcare. This will include assessing commercial reimbursement rates for primary and chronic care services, the role of price and utilization in healthcare spending, and prescription drug spending as a driver of total cost of care.

In recent years, Delaware has acted to improve healthcare quality and bend the healthcare cost growth curve by:

• Implementing healthcare quality and spending benchmarks;
• Creating the Primary Care Reform Collaborative to make recommendations on payment reform, value-based care, workforce and recruitment, and primary care investment and access;
• Implementing a state reinsurance program under the federal 1332 waiver program to stabilize the health insurance marketplace;
• Issuing regulations to require the registration of pharmacy benefit managers; and
• Lifting payment and other barriers to ensure that providers could easily transition to providing telemedicine services, including phone-based visits during the COVID-19 pandemic.

To further help bend the healthcare cost growth curve, in 2019, Senate Bill 116 of the 150th Delaware General Assembly directed the DOI to create the Office of Value-Based Health Care Delivery to “reduce health-care costs by increasing the availability of high quality, cost-efficient health insurance products with stable, predictable, and affordable rates.” SB 116 charged the Office with three tasks:

1. Establish affordability standards for health insurance premiums based on recommendations from the Primary Care Reform Collaborative and annually monitor and evaluate these standards;

2. Establish targets for carrier investment in primary care to support a robust system of primary care by Jan. 1, 2025; and

3. Collect data and develop annual reports regarding carrier investments in healthcare, including commercial reimbursement rates for primary and chronic care services.

Vogel has been involved with healthcare management for over 25 years, with experience in hospitals and medical practices, state government, insurance, and consulting. She most recently served as the director of population health initiatives for Nuvance Health System in Connecticut, where she developed solutions to improve clinical outcomes, increase quality of care, and control healthcare costs through implementing a nurse care management program, a clinical pharmacy program, and through integrating behavioral health within primary care practices. Her experience in healthcare reform also includes leading the State of Connecticut’s Office of Healthcare Access and evaluating Certificates of Need. The position, funded by the department, was made necessary by several legislative mandates related to healthcare affordability and pharmacy benefits.

 

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