Delaware Public Media

Primary care reimbursement bill moves to House floor

Jun 20, 2018

A bill seeking to further reimburse Delaware’s primary care physicians cleared the House Health Committee Wednesday.

The proposed legislation would require insurance providers reimburse primary care and other front-line medical professions in Delaware at the same rate as Medicare for the next three years. It would also create a Primary Care Reform Collaborative, and require insurance providers to participate in the Delaware Health Care Claims Database.

Family Physician Dr. James Gill, MD is President of Family Medicine at Greenhill, a small private practice in Wilmington. He points to a shortage of primary care physicians in the First State, saying several of his colleague’s practices have closed down or switched to concierge service in part because of lower salaries, long hours and a need to hire people to login patient data not required of other medical fields.  

“So not only are we getting paid less just for the work we do seeing a patient, but we’re not being paid anything to do that extra work, and we have to do three, four, five, six times as much as a specialist would need to do,” said Gill.

Gill says the reimbursement would mostly go toward alleviating a need for increased staff resulting from that extra work, “In order to take care of patients, yeah doctors see the patients, but we really need nurses and medical assistants and nurse practitioners and other people to keep track of people’s chronic diseases.”

According to the bill, the national average for insurance reimbursement for primary care is between 120% and 140% of Medicare rates, while in Delaware the rates are as low as between 65% and 85% of Medicare.

State Insurance Dept. officials say the bill is likely to increase premiums by less than one percentage point for some Delawareans.

A petition in favor of the measure with more than 2,700 signatures includes an article by a Delaware MD saying the state is in a primary care crisis.

Highmark Blue Cross Blue Shield Delaware declined to comment on the bill, which already easily passed the state Senate.