Two state health subcommittees focused Monday on the rising cost and utilization of health care.
Those costs are the basis of predictions about how many healthcare services employees and retirees will use and are used to determine insurance premiums and more.
At a joint SEBC Financial and Health Policy & Planning Subcommittee meeting Monday,
Chris Giovannello of Willis Towers Watson said expenses are rising about 8% per member year over year.
He compared costs between March 2021-Feb. 2022 with March 2022- Feb 2023.
During that period, for admission rates, maternity represented the largest number of hospital admissions at 39%, or 22.2 per 1,000 admissions, a 4% hike from the previous year.
Surgical admissions, though, saw the biggest increase in numbers. They were up 13.4% to 10.5 per 1,000 admissions, up from 9.3 in the previous year.
The overall length of stay declined, Giovannello said.
Utilization of mental health outpatient services increased the most at 9.7%, from 2,283.7 per 1,000 to 2,504.1. That was followed by emergency room visits at 9.1%, from 1,912.2 per 1,000 to 2,085.4, and laboratory services at 6.8%, from 7,198.8 per 1,000 to 7,688.4.
Related Story: State employee insurance premiums to rise 9.4%
Most routine prescription drugs, 89.6%, come from retail drug stores, compared to 8.7% for mail order drugs, and 1.7% for specialty drugs.
Giovannello said cost increases are due to both price increases, due in part to the pandemic and inflation, and increases in utilization, and that they will discuss what is driving those increases later in the spring or early summer.
The state’s health care plan separates people into five different categories, healthy, stable, struggling, at risk and in crisis.
The more dire the category, the larger the number of older people, usually, and the more it costs the state to cover the insurance, even though they usually make up less of the insured population, the slides showed.
Walt Mateja, with IBM Watson Health, said that it was startling to see that the at risk, struggling, and in crisis categories make up around 46,384 people, compared to the around 56,853 people in the healthy and stable categories.
ROLL CALL VOTES: The suggestion of requiring a roll call vote for any subcommittee recommendations was a touchy subject.
William Oberle, an appointee from the Delaware State Trooper’s Association, said he has no issue with the subcommittee holding a roll call vote and that it would be good for people to go on the record.
“Given the gravity of the issues that we deal with and the ramifications of our decision, I think it’s appropriate to go on the record and clearly state the outcome of each referral to the SEBC,” Oberle said. “It needs to, I think, culminate in a yes or no on a particular issue that’s referred to the SEBC. So that they have a clear understanding of where the subcommittees stand.”
Robert Scoglietti, the deputy controller general, said that he would also appreciate there being a roll call votes.
State Treasurer Colleen Davis said she disagreed and doesn’t want staff members to be held liable for decisions made to the same degree that elected officials, like her, are.
“When I’m walking in a parade and I’m shaking hands and kissing babies, I expect someone to call me out for a decision I made,” Davis said. “I don’t expect my staff to get a phone call at home, or to get stopped at the pharmacy or wherever, to be called out for a recommendation they made. Not necessarily an absolute decision that is made, like it is at the SEBC. There’s a difference.”
Matthew Rosen, a senior policy advisor with the Office of the State Treasure, is a member of the health policy and planning and the finance subcommittees and was appointed by Davis.
RECORDING SUBCOMMITTEES: During the subcommittee’s public comment portion, Thomas Pledgie talked about the importance of transparency and said that included roll call votes and recording meetings so they would be available to the public.
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