Why Should Delaware Care?
The Diamond State Hospital Cost Review Board is a state oversight board that could shed new transparency into the cost of health care in Delaware. But it has faced pushback ever since its introduction last year in the General Assembly. The resignation of the board’s chair adds a new wrinkle to the board’s future.
The chair of a Delaware board charged with reducing the cost of care at state hospitals stepped down last month after a spat with Gov. Matt Meyer over whether the public body should hold meetings amid an ongoing lawsuit that threatens its future existence.
In a letter to Meyer sent on June 7, Rick Geisenberger – the former Delaware Secretary of Finance under Gov. John Carney – recounted how he had declined the governor’s request to cancel meetings of the board, saying instead that the public body was “duly authorized” by the legislature and had a responsibility to perform its business “impartially and free from undue influence.”
“You have stated to me that holding any further meetings of the Board at this time would be a waste of State resources in light of recent developments and uncertainties,” Geisenberger said in a reference to an ongoing lawsuit filed by ChristianaCare challenging the board’s authority.
In the letter, Geisenberger also declared his respect for what he called ”gubernatorial prerogative” and therefore offered his resignation as chair of the board that is formally called the Diamond State Hospital Cost Review Board.
Later that month, Meyer accepted the resignation. David Singleton, the former Secretary of Finance in the Ruth Ann Minner administration and a longtime banking executive, will fill the seat.
Geisenberger will remain a member of the board without the chair role.
In an interview with Spotlight Delaware, Geisenberger said he viewed the governor’s demand to not hold meetings as undue influence.
“All of government would shut down if the argument was, ‘Whenever there’s a court case you stop meeting,’” Geisenberger said.
The governor’s office declined to comment on the letter due to the pending litigation surrounding the board.
Delaware’s hospital cost review board serves as an oversight mechanism for the state to review hospital budgets and spending. In 2024, former Gov. Carney signed House Bill 350 into law, creating the board.
It came after a sustained, and ultimately failed, lobbying effort by hospitals to block the bill.
Following its passage, ChristianaCare — Delaware’s largest and most influential hospital system — filed a lawsuit against the state that challenged the constitutionality of law. In its court filings, the hospital system called the cost review board “draconian,” pointing particularly to its ability to veto hospital budgets it deems excessive.
In June, a judge allowed the lawsuit to continue following arguments over a motion to dismiss the case.
“The act wrests power from hospital boards and instead imbues the state’s executive branch with authority to direct the internal operations and affairs of privately-owned hospitals,” the complaint filed in the Delaware Court of Chancery said.
A report released by the state’s health department earlier this year said Delaware exceeded its self-imposed health care spending goals for the third consecutive year in 2023.
Health care spending in Delaware increased 9.1% between 2022 and 2023 to nearly $11 billion, according to an annual assessment released by the Delaware Department of Health & Social Services in May.
On a per-capita basis, Delawareans spent $10,588 on health care in 2023 – or about an eighth of the median gross household income for the state.
Throughout his tenure, Meyer has expressed he does not believe the board addresses the increased health care spending in the state. Soon after his inauguration, the governor appointed two longtime ChristianaCare executives to the board after Carney appointed five of the seven voting members on his way out of office — only one of whom was connected to a hospital.
Additionally, lawmakers froze $1 million in operational funding to the board in June, but ultimately restored it prior to the end of the legislative session.
The cost review board is scheduled to meet on Aug. 12.
Transparency Notice
David Singleton serves on the board of advisors for Spotlight Delaware. Advisors have no role in the editorial decision-making of Spotlight Delaware. For more information, see our Boards page.
