Delaware moved first. Here is the evidence.
Delaware’s program was announced July 6; network testing launched July 13; the first production cohort is targeted for January 1, 2027.
July 6 — the program announced
The Delaware Department of Health and Social Services and the Delaware Health Care Commission announced a statewide Rural Health Transformation Program initiative supporting real-time insurance verification and prior authorization — implemented in collaboration with DHIN, the state’s health information exchange, and Smart Health Network. Delaware didn’t choose a vendor — it wrote shared, neutral infrastructure into its federal Rural Health Transformation plan, building on infrastructure the state already trusts.
“Technology should make healthcare easier to navigate, not more complicated. This initiative will help clinicians spend less time managing paperwork and more time caring for patients.” — DHSS Secretary Christen Linke Young
“The promise here is simple: cut the paperwork, not the care.” — Dr. Neil Hockstein, Chair, Delaware Health Care Commission
July 13 — network testing launched
More than 200 participants, in person and online, at the University of Delaware. Insurance Commissioner Trinidad Navarro and Dr. Neil Hockstein opened the launch, joined by DHIN CEO Dr. Jan Lee and SHN CEO Paul Meyer — followed by an end-to-end electronic prior-authorization demonstration and business and technical working tracks. The first health plan connected to the test network and began testing prior-authorization workflows; a state HIE connected self-service, straight to the hub; providers, networks, and HIEs are connecting — all on synthetic data, end to end.
What Delaware published as its targets
Delaware’s published Year-3 targets: 75% reduction in prior-authorization response time · 85% clean claims rate · 90% reduction in coverage-error first-pass denials.
What comes next
The national CMS-0057 readiness Connectathon convenes October 14, with a Delaware satellite and satellite sites open to every state. The first production cohort is targeted for January 1, 2027 — cohort scope defined by the participation agreements executed by November 30, subject to completed agreements, credentials, conformance, and launch checks.
Press and materials
Delaware DHSS announcement → · Axios: Rural health funds to fix prior authorization → · LIFERS with Christina Farr (video) → · The Delaware briefing deck (PDF) → · All news →
Delaware first, not Delaware only — the playbook Delaware is running is published for every state. Read the Four Actions playbook →