5 Things Alaska: House Health Bills, Sen. David Wilson, Real Talk on Juneau Politics

Like our friends in the House, we waited until the last minute to get you February’s edition of 5 Things We’re Watching in Alaska health care. We’ll be back to our regular release of our monthly newsletter in the third week of the month come March, but until then, thanks for reading our stuff.


DJ 5 Things Signature With help from Emily Boerger,
Sara Gentzler, and Marjie High



1. Costs in health care: deck chairs and the Titanic

Cost is increasingly the paramount issue in health care today. That’s not news. But, for as common as this knowledge is, we aren’t always as honest about cost as we could be. We also sometimes try to make it more complicated than we should. In this series, I suggest there are really only two kinds of costs: deck chairs and the Titanic.

I spend a fair amount of time with numbers, data, and metaphor in the series. But, after stewing in the national health expenditure data from CMS for a while, this is the bottom line: Market leverage has more impact on driving cost increases than both utilization and the costs from service delivery combined. I haven’t done the full historical analysis, but it appears that this could be the first time in American health care history that this is the case.


2. Lessons from the outside on behavioral health

The Dunleavy administration appears to be continuing to implement behavioral health reformsenvisioned in SB 74, including the creation of a BH-ASO. The model will attempt to bring a level of system coherency to an otherwise largely cottage industry in Alaska. I think it’s an important  and positive step, one that will likely save money and improve outcomes.

I spoke with some of the national leaders from Beacon Health Options recently. Beacon is a national managed behavioral health care organization, and has a footprint across the country. We talked about their experience in Colorado, Arkansas, and Washington State. I then asked them to apply that experience to work they hope to do in Alaska. (They’re one of the respondents to the BH-ASO RFP the state released last year.) Their primary lesson: creating trust and collaboration with providers is mission-critical to success.

3. House health bills we’re watching

Over a month after Alaska’s 2019 legislative session began, the House of Representatives officially elected leadership and announced its committee assignments last week. With the organization of committees comes the referral of new legislation.

Ten bills have been referred to the House Health & Social Services Committee. In this piece, Senior Reporter Emily Boerger gives a rundown of some of the early bills we are tracking as work in the House gets underway. They include the House’s Medicaid work requirements bill as well as a bill that would continue the work of the Statewide Suicide Prevention Council.

4.  Video: Senator David Wilson

Senator David Wilson is the Chair of the Senate Health & Social Services Committee in the Alaska State Legislature. He joins us in this edition of “What They’re Watching” to discuss substance use and abuse.

“We have pilot projects going on within the one hospital that’s already showing a 50 percent reduction of utilization within the first six months of their pilot program…They have 50 patients that they’ve taken an approach to looking at them and involving them with an intensive case management sort of approach to see what they really need.”


5.  Real talk on Juneau politics

Sometimes, we can all use a little more authenticity in our day, particularly when it comes to politics and health policy. So, I thought I’d flag this commentary from Sen. Gary Stevens, who, while a senior legislator, isn’t too excited about being out of his depth on health policy. It’s real talk.

Likewise, if you’re not reading Alaska Landmine, let me introduce you. Jeff Landmine, who spoke at last year’s State of Reform conference, is providing some of the best, most authentic insights on Juneau since Amanda Coyne stopped writing. Some of his work is getting picked up by mainstream outlets as ‘breaking.’

Taken together with Nat Herz at Alaska Public Media, The Midnight SunMust Read Alaska, and James Brooks at the ADN, the coverage of Juneau is really strong right now. It’s actually something of a high-water moment for Alaska media in the face of cuts in outlets across the state.