5 Things Alaska: AG sues Purdue, Special session, Bill Popp

DJ is on a (much needed) vacation, so he left me the keys for this edition of 5 Things We’re Watching. Normally, I’m reporting on health policy or producing our podcasts, but today you get me in email form, too.

Anyway, enough about me. On to What We’re Watching in Alaska health care and health policy for November.

Kylie Walsh
State of Reform

1.  Attorney General sues Purdue

Attorney General Jahna Lindemuth became the latest Attorney General to file a lawsuitagainst Purdue Pharma, the maker of OxyContin. The suit alleges that Purdue used deceptive practices promoting OxyContin for long-term chronic pain with little supporting evidence. A multitude of states are suing drug companies because of the opioid crisis, including WashingtonOhio, and New Jersey.

Alaska’s lawsuit follows President Trump declaring the opioid epidemic a national public health emergency.  The Commission on Combating Drug Addiction and the Opioid Crisis released their recommendations for how to deal with the crisis. Key highlights included outreach, prescribing guidelines, data collection, and treatment. These recommendations overlap with Governor Walker’s continued multi-pronged approach to Alaska’s opioid epidemic.

And while opioid-related deaths have increased in Alaska – 745 deaths from 2008 to 2016 – so have meth-related deaths, increasing from 5 deaths in 2008 to 65 deaths in 2016. There were a total of 233 meth-related fatalities from 2008 to 2016. While this is only about a third of the opioid-related deaths, it shows that Alaska’s growing substance abuse crisis is not limited to opioids.

2.  Putting the Special Session in context

In case you missed it, the Legislature began its fourth special session on Oct. 23.  That session now remains in limbo until Nov. 21 after the Senate adjourned without the House’s approval. We’re not expecting to see anything else come out of Juneau before the special session ends.

The Legislature focused on two topics: criminal justice and a flat wage tax. Senate Bill 54 on criminal justice passed, which reverses many pieces of last year’s controversial criminal justice overhaul by restoring tougher penalties for minor crimes. Despite some concerns, the Senate passed the House’s amended version.

The Senate adjourned without passing the Governor’s proposed income tax bill of 1.5 percent of wages. The proposal would have raised between $300 million and $325 million. This projection is still short of the previous budget shortfall of $2.5 billion, which caused significant budget cuts across the board including a $30 million cut for DHSS. The Senate Majority had called for“reducing government budgets and instituting a spending limit” instead of raising an income tax. Governor Walker expressed his disappointment with the Senate’s decision.

3.  Video: Bill Popp

Bill Popp has been the the President and CEO of the Anchorage Economic Development Corporation since 2007 and has worked in Alaska for more than 40 years. At the AEDC, he works to encourage growth and diversity in the Anchorage economy, and improve the standard of living of Anchorage residents.

Bill joins us in this edition of “What They’re Watching” to discuss the impact Alaska’s fiscal crisis has on the health care system and innovations: “Until we get the state’s fiscal crisis solved, which is a major elephant in the room that is pretty much sucking all the air out of the room, there’s no air left to have major policy discussions on issues like healthcare, not in a significant way. “

4.  Tax reform implications for Alaska

Both the Senate and the House have released their tax reform plans. While there is some agreement, like increasing the standard deduction, the Senate plan keeps several deductions that the House plan would eliminate, including the medical expense deduction for expenses over 10 percent of adjusted gross income.

If recent ACA reform and repeal efforts are any indication, Republican-controlled Congress will likely have a difficult time coming to a consensus on tax reform, especially with the Senate’s recent addition repealing the individual mandate. I wouldn’t be surprised if the medical expense deduction becomes a sticking point. And with Alaska having the some of the highest health care costs per capita in the nation, repealing the medical deduction would hurt Alaskans the most.  It will be interesting to see where Sen. Murkowski comes down on this given her prominent advocacy on health costs in Alaska during the ACA reform debate.

5.  Alaska joins care coordination network

Alaska is moving forward with an implementation of Collective Medical Technologies’ real-time care coordination platform. The platform allows providers and plans to access data on every patient and member through the integration of facilities’ electronic medical records system. In Washington, Collective Medical saw a 24 percent reduction in narcotic prescriptions from the ED. In Oregon, they saw nearly a 40 percent decrease in visits by high utilizers in the 90 days after an initial care guideline was created in their system.

interviewed Dr. Ben Zaniello, Chief Medical Officer and Vice President of Product at Collective Medical, to learn more about the applications. According to Dr. Zaniello: “We’re a technology company based in Salt Lake City, and I don’t want to undersell our technology, but at the same time, I always say we don’t save lives at Collective Medical. We enable providers to do a better job at their work, which is saving lives, and I think that’s an important distinction.”

In other care coordination news, the last time we talked to DHSS we were told the contract for the Medicaid Coordinated Care Demonstration Project is still being negotiated. Stay tuned for more updates.