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A State of Change: Delaware hospitals grapple with changing healthcare landscape

Delaware is known as the “Small Wonder,” but when it comes to healthcare, the state is facing some big issues. 
Despite Delaware's size, the challenges can differ drastically for health care systems above and below the Chesapeake & Delaware Canal. They can even vary from Kent County to Sussex County. A two-part article series by the Medical Society of Delaware takes a look at how the state's hospitals are addressing the issues – together and apart. The first article focuses on New Castle County.

NEW CASTLE COUNTY: In 2013, when Brian Dietz arrived at Saint Francis Health System as the interim CEO, he was immediately struck by the cost of providing health care in Delaware. According to the Centers for Medicare and Medicaid Services, per capita healthcare spending in Delaware is among highest in the country.

Delaware has a large number of residents on Medicare and Medicaid, which lag behind private insurance when it comes to reimbursement rates. Their numbers are growing. Dietz became the president and CEO of the Wilmington hospital in 2014, the same year that Delaware adopted Medicaid expansion through the Affordable Care Act, which upped the number of Medicaid patients.

Meanwhile, the ACA has put pressure on hospitals to improve healthcare outcomes, a mission that typically involves hiring staff and buying equipment. But the emphasis is also on reducing costs.

Situated in Philadelphia’s looming shadow, New Castle County hospitals face competition from large systems attached to universities. Talk about keeping up with the Joneses. “It’s difficult to have the services offered locally at the prices necessary to be competitive when you’ve got the larger facilities up in Philadelphia,” Dietz noted.

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