- Delaware Health and Social Services

Recommendations for all services:

Build methodologies specific to each service that is purchased.
Develop a long-term roadmap for assigning the periodicity of updates of rates for all services.
Augment the existing staff to develop and maintain rate methodologies and clearly define roles/responsibilities for those staff.
Enter in a more formalized public notice process to inform providers & other stakeholders when rate changes are being contemplated.
During rate methodology changes, build a project specific workplan to include meetings with providers throughout the project.
For all major service categories, update provider manuals to include descriptions of rate methodologies in detail.

Specific service recommendations:

Modernize rate methodologies for home and community based services (HCBS) to capture provider costs and independent market-based costs for comparison. This includes those HCBS provided by the Divisions of Developmental Disabilities Services, Services for Aging & Adults with Physical Disabilities, and Substance Abuse and Mental Health and for child care services provided by the Division of Social Services.
When rates are negotiated through the procurement or contract negotiation process, DHSS Divisions should use a rate corridor as part of the bid process.
The Division of Medicaid & Medical Assistance (DMMA) should look at reviewing the methodologies for inpatient hospital services, outpatient hospital and nursing facilities.

The report and findings are available online

Independent Study of Rate Methodologies for Services delivered by the Divisions within DHSS