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\u00a0NEW CASTLE \u2013 The Delaware Department of Health and Social Services (DHSS) and the Delaware Health Care Commission today announced a new Rural Health Transformation Program (RHTP) initiative that will support real-time insurance verification and prior authorization across the state.<\/p>\n
The project will leverage the Delaware Health Information Network (DHIN), Delaware\u2019s statewide health information exchange, and Smart Health Network, a technology platform that helps providers and payers exchange administrative information more efficiently, to improve connectivity among clinicians, payers, health systems, and patients.<\/p>\n
Smart Health Network\u2019s infrastructure helps create a shared connection point that allows participating providers and payers to exchange information using common standards rather than maintaining numerous individual connections.<\/p>\n
Together, DHIN and Smart Health Network will support more efficient exchange of administrative information related to insurance eligibility, prior authorization, and other health care transactions, helping reduce administrative burdens, improve care coordination, and support faster access to care.<\/p>\n
\u201cTechnology should make health care easier to navigate, not more complicated,\u201d said DHSS Secretary Christen Linke Young. \u201cThis initiative will help clinicians spend less time managing paperwork and more time caring for patients.\u201d<\/p>\n
Prior authorization and insurance verification requirements can delay access to care and increase administrative burdens for providers. Nationally, physician practices spend an estimated 13 hours each week completing prior authorization-related tasks, according to the American Medical Association.<\/p>\n
Through this investment, Delaware will build upon existing statewide infrastructure to improve interoperability and support more efficient information sharing across the health care system. For example, provider offices often must navigate multiple payer portals, submit documentation through different systems, or make phone calls to verify coverage and obtain prior authorization for services. By supporting more standardized electronic transactions between providers and payers, the project will help streamline these processes and reduce administrative workload.<\/p>\n
DHIN serves as Delaware\u2019s designated statewide health information exchange and maintains secure connections with hospitals, health systems, federally qualified health centers, laboratories, pharmacies, and provider organizations throughout the state. The project will build on DHIN\u2019s existing infrastructure while incorporating Smart Health Network\u2019s enhanced data integration, analytics, and interoperability tools.<\/p>\n
The project supports broader goals of Delaware\u2019s multi-year Rural Health Transformation Program by improving access to care, modernizing health care infrastructure, supporting providers, and enabling more innovative models of care delivery. It also complements other RHTP investments focused on expanding access to services, growing the health care workforce, and improving health outcomes in rural and underserved communities.<\/p>\n
\u201cAs a physician, I have watched prior authorization consume time that belongs to patients,\u201d said Delaware Health Care Commission Chair Dr. Neil Hockstein. \u201cThe promise here is simple: cut the paperwork, not the care. A neutral hub that every payer and provider can join once \u2014 and that patients can actually see into \u2014 is the change the front lines have been waiting for.\u201d<\/p>\n
\u201cDelaware already trusts DHIN to move health information securely across the state,\u201d said Delaware Health Information Network CEO Dr. Jan Lee. \u201cThe Smart Health Network extends that trusted, neutral foundation to the administrative transactions that sit alongside care. We are building on what Delaware already has to support patients, clinicians, and payers.\u201d<\/p>\n
\u201cDelaware decided to treat this like the public infrastructure it is \u2014 neutral, and designed around patient interest,\u201d said Smart Health Network CEO Paul Meyer. \u201cThe hub connects everyone through a single integration. Delaware is first, but the network is built for every state.\u201d<\/p>\n
By leveraging DHIN\u2019s established statewide network, the project avoids duplication of existing infrastructure, accelerates implementation, and ensures compliance with state and federal privacy and security requirements. Smart Health Network\u2019s tools will enhance the usability of DHIN\u2019s trusted data by supporting advanced analytics, visualization, population health management, and program evaluation capabilities.<\/p>\n
This project is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $157,394,963.86 with 100 percent funded by CMS\/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS\/HHS, or the U.S. Government.<\/p>\n
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