COMMENTARY: Driving down Delaware’s healthcare costs, improving outcomes

The cost of providing healthcare to state employees (including those in school districts and charters), retirees, other groups covered under the state’s plan and covered family members — approximately 122,000 people in all — is climbing at an alarming rate.

Between fiscal years 2010 and 2015, healthcare costs for this group grew by 34 percent. Currently, that figure tops $700 million annually. Projections by the Office of Management and Budget (OMB) indicate the tab might be more than $1.2 billion by Fiscal Year 2022. With public education and public assistance programs like Medicaid, already accounting for about 60 percent of state spending, the growth in the costs of state health care benefits cannot be sustained.

I do not want to see these benefits cut. Nor should state taxpayers — many of whom are also struggling with higher health care costs — be asked to shoulder an additional burden. Rather, I support helping beneficiaries to become better consumers of healthcare services and better stewards of their own health.

Many people do not fully comprehend their health insurance plans, what resources are available to them, and what choices they can make to reduce expenses.

According to a survey conducted by supplemental insurance provider Aflac, more than 40 percent of consumers spent 15 minutes or less researching their health plan options. Additionally, the polling reportedly found that 42 percent of workers say they waste up to $750 each year on mistakes with their insurance benefits, and 73 percent have trouble understanding what is covered by their policies.

Making informed choices can have an enormous impact on the bottom line for the state and beneficiary. Consider the obvious example of choosing treatment at a hospital emergency room over an urgent care center. An ER visit costs approximately $1,195, while urgent care is only about one-tenth that cost ($120). Co-pays for state workers using these services are $150 for the former as opposed to $15 or $20 for the latter.

The same case can be made for medical imaging. On average, imaging conducted by a hospital facility can be more than twice as expensive as the same scans performed at a non-hospital affiliated freestanding facility.

Lyndon Yearick

The state of Delaware is helping the people it covers become better consumers of healthcare. It is currently strongly encouraging benefit-eligible state, school district, charter school, higher education and participating group employees to complete a free online course: “Being A Wise Health Care Consumer: What’s In It for Me?” The Statewide Benefits Office designed the course, which takes approximately one hour to complete, to help employees use a host of tools found on the Consumerism Resource Link (de.gov/healthconsumer) to make informed choices that will save them money and maintain or improve their health and well-being. So far, over 9,000 employees have completed the course. Survey results indicate that 93 percent of participants agree that they learned ways to save money and improve/maintain the health and well-being of themselves and their family.

The course mirrors the goal of legislation (House Concurrent Resolution 81) I successfully sponsored this year, encouraging state health plan participants to take action to slow the growth of expenditures.

Being an educated consumer is only one-half of this equation. The other half is for members to take responsibility for their health.

This is more than just preaching about exercising more and eating better. It is about avoiding the health issues that fundamentally impact the quality-of-life for thousands of Delawareans and saving the state taxpayers tens-of-millions of dollars annually.

Consider that our state has an adult obesity rate of 29.7 percent, which places us 28th nationally.

Obesity and physical inactivity place people at increased risk for heart disease, cancer, and diabetes. Delaware’s Statewide Benefits Office reports that more than 11,000 health plan participants have diabetes requiring treatment and medication totaling $48 million annually. Additionally, 12,400 plus members have cancer with a total cost of $81.5 million; approximately 21,000 members have high blood pressure costing $33.2 million; and 5,500 plus members have coronary artery disease with a cost of $28.9 million.

Of course, not all disease can be prevented by eating nutritiously and avoiding a sedentary lifestyle, but these things can pay substantial benefits.

Dr. Delos Cosgrove, CEO of Cleveland Clinic, says 60 percent of healthcare costs arise from chronic diseases (i.e. cardiovascular disease, diabetes, stroke, pulmonary disease and certain cancers) that are largely preventable.

Cleveland Clinic instituted wellness measures, giving members of its employee health plan financial incentives to improve their behaviors. Over four years (2009-2013) the clinic’s employees collectively lost more 330,000 pounds, while hundreds of workers quit smoking. In addition to having a healthier staff, the clinic saved $15 million in employee healthcare costs.

If we are going to control expenses and maintain a high level of benefits, everyone covered by the state health plan needs to be engaged in making prudent choices in the selection of their medical services and the safeguarding of their own well-being.

EDITOR’S NOTE: Rep. Yearick is a Republican legislator representing the 34th Representative District which contains the municipalities of Camden, Wyoming, Woodside and a portion of Dover. He was recently elected to his second term in office.

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