Hi. We’re in…Delaware. Yes, the home of tax free shopping is the second state (sorry) to pass a sweeping healthcare standards bill that seeks to increase investment in primary care in order to decrease overall spending on healthcare. The first state to do so, Rhode Island, saw a statewide push for investing in primary care to improve overall quality of care has been returning beneficial results for its residents.

Primary care has been facing challenges for decades now. The hours are long and the compensation less than in many other areas of practice. Even so, primary care plays a critical role in managing most patient’s care; several healthcare systems are built on this very model: Kaiser Permanente and GroupHealth offer (or offered) care through a cooperative or managed care model, emphasizing primary care. The idea is that focus on primary care identifies patient problems at an early – and less expensive to treat – stage. 

The Delaware legislature is attempting to emphasize investment in primary care by mandating that insurers spend a certain percentage annually on primary care. Certain payors who spend the established ratio on primary care are then permitted to sets caps on price growth in areas of care. Finally, the bill mandates a certain percentage of care be provided through payment models that are not pay-for-service, considered to be a major driver for exponential cost increases year after year.

Rhode Island implemented a similar series of standards in 2010, and have seen encouraging results. Rhode Islanders pay less, with improved quality, than comparator populations. Researchers note that these trends took a few years to become obvious, so require political will. Which, some might say, tends to be in short supply when looking for long-term results. For example, the Delaware bill includes sunset provisions requiring lawmakers to renew aspects of the law before 2027.