5 Things Alaska: Medicaid redesign, Beacon protests BH-ASO award, Amy L. Mackin

The tourists are in town and Alaska has arrived on the cusp of summer! That means things will slow down through much of the economy. But, it’s also sometimes the time when things might move in health care, when the pressure is a little lower and folks can be more strategic. We’ll see. But, until then, here are 5 Things We’re Watching in Alaska health care for May 2019.

 

 


With help from Emily Boerger

1. BH-ASO awarded to Optum; protested by Beacon

A central element of Alaska’s 1115 waiver is the Behavioral Health – Administrative Services Organization (BH-ASO). The waiver was approved in March following more than a year of negotiation with CMS. Following a DHSS RFP, Optum was named the “apparently successful bidder” in a process that a second bidder, Beacon Health Options, immediately protested.

In its protest letter, Beacon says DHSS erred in awarding Optum points for being an Alaska-based organization, among other concerns. Optum is based in Minnesota, according to the protest. Following on the heels of the reversal of the contract with Wellpath to operate API, and the rumored “hold” placed on the Medicaid demonstration award, it appears procurement methods may be getting in the way of momentum for reform efforts.

 

2. $100k to redesign Medicaid. In 1 month.

Last week, the State of Alaska released an RFP offering $100k for one month of work to write a “Proof of Concept” paper. The paper should outline how to move certain Medicaid beneficiaries into a “private market insurance option.” It should also include work requirements and a block grant model.

The document reads like an ideologically driven tool rather than a policy development tool. For example, moving certain Medicaid beneficiaries into the private sector will be much more expensive than the current approach. This isn’t because the private market is more expensive (though it is). It’s primarily because the state doesn’t pay for these folks now. They currently cost the state next to nothing… Here’s what I mean.

3. Convening Panel set to meet later today

In a few hours, we’ll host our Convening Panel meeting for our 2019 Alaska State of Reform Health Policy Conference coming up on October 2nd. This meeting is where we begin to sort through the various topics, sessions, and speakers that you’ll see take shape this fall with about 300 of Alaska’s most prominent policymakers and market leaders in the room.

We’ll have a Topical Agenda for you to review in about a month. But, if you want to get signed up now while Early Bird rates are still in effect, you can do so here. If you already know you want to be in the room with us, you can save yourself a few bucks and get signed up now!

4. Video: Amy L. Mackin, Hall Render

Amy L. Mackin is an attorney at Hall Render, Killian, Heath & Lyman. She joins us in this edition of “What They’re Watching” to discuss best legal practices for providers.

“Best practices for providers would really be to understand what’s in their contracts, what’s in the provider manual that’s being provided to them by the payer, and really get a better sense of exactly what’s going to be required of them. Once they have that information, they can more easily put into practice exactly the new arrangements that are coming down the pike.”

 

5. “Medicare for All” and its price tag

Last week, “Medicare for All” legislation received its first Congressional hearing. The hearing, which attracted a great deal of partisan debate, discussed many of the unanswered questions regarding the shift from a patchwork payer model across various lines of business, to a single-payer health care system. Reporter Emily Viles covered the hearing here.

Following the hearing, the Congressional Budget Office released a report suggesting the process of creating such a plan could be more difficult than originally anticipated. The report explained how a single-payer system could be constructed, how it could be paid for, and some of the challenges that lawmakers face in establishing rules and regulations for the Medicare for All model.