Frequently Asked Questions

About the Website

1. What is the purpose of this website? The CostAware website is how the Delaware Health Care Commission (DHCC) will share its assessments of Delaware’s health care systems. It will share comparisons of health care activity, costs and outcomes for health care services, providers, and programs. These findings are intended to inform collaborative initiatives and programs among health care providers that will promote access to high-quality affordable care.
2. Why can’t I see the names of hospitals or providers? This initial version of CostAware is the first phase of the DHCC’s effort to increase transparency in performance of the Delaware health care system. It is anticipated that future versions of CostAware will include more detailed cost, utilization, and quality information.
3. How can the information be used? CostAware webpages are expected to increase awareness of Delaware’s health care variations in cost and quality. As CostAware reports are developed, they will provide information that allows consumers, employers, and other purchasers of health care to make informed decisions about where to seek health care that meets their needs.
4. Who developed the website? The CostAware website was developed by the Delaware Health Care Commission (DHCC) and the Department of Health and Social Services (DHSS).
5. Are the costs for Delaware hospitals only? Currently, yes. DHCC and DHIN are exploring options for providing similar information for hospitals located in neighboring states in future versions of CostAware.

Frequently Used Terms

1. What is the difference between the APCD and the DHIN? Delaware Health Information Network (DHIN) is the State-sanctioned Health Information Exchange (HIE) and manages the Health Care Claims Database (HCCD). The HCCD is Delaware’s name for what is often identified as an All-Payer Claims Database (APCD) in other states.
2. What is an Accountable Care Organization (ACO)? ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide coordinated high-quality care to their patients. ACOs establish financial incentives for providers to promote best practice care to the right persons at the right time while improving patients’ overall health care experiences. The ACO initiative is a major piece in Delaware’s Road to Value – a plan to transform the way that health care is delivered and paid for in the state. For more information on the Road to Value, visit: https://www.choosehealthde.com/Road-to-Value.
3. What are CPT codes? Current Procedural Terminology (CPT) codes are developed and maintained by the American Medical Association (AMA). These codes identify and categorize medical procedures performed by any provider.
4. What are MS-DRGs? Medicare Severity Diagnosis Related Groups (MS-DRGs) are used to categorize patients with similar clinical characteristics who have received similar health care services. Payment amounts are sometimes determined by the MS-DRG. MS-DRGs can be used to compare costs across health systems, regions, and states in a meaningful way.

About the Methodology

1. What is the data source? The Delaware Health Care Claims Database (HCCD), maintained by the Delaware Health Information Network (DHIN). This database is a collection of claims data from Medicare, Medicaid and commercial health insurers and is the largest repository of claims data in the state. For more information about the HCCD, visit: https://dhin.org/healthcare-claims-database/
2. Why do prices differ across hospitals and providers? Many factors contribute to price variation including differences in clinical practice, billing practices, contractual relationships between payers and providers and payment systems used by health insurers.
3. Why are the unit costs would be grouped by ACO? ACO groupings were chosen to be consistent with the CMS quality measures displayed on the CostAware website. CMS reports this data by ACO. 
4. How was ACO data calculated? ACO calculations were based on the providers associated with the ACO and their entire panels having a claim in the HCCD. Because primary care practices belonging to ACOs may not have onsite imaging facilities or their own labs, these services are often provided at other locations. When this occurs, the cost of an imaging procedure or lab service is assigned to the patient’s ACO based on patient attribution. As an example, Jane Doe receives an MRI at the independent anonymous imaging center. Because Jane is attributed to a physician practice associated with ACO 1, the cost of Jane’s MRI is assigned to ACO 1 for purposes of calculating the average cost.