5 Things We’re Watching – Alaska, October 2013

This year’s conference was a great event, with as much good ‘informal’ hallway talk as there were interesting ‘formal’ panels and presentations.

Here are 5 Things we heard about at the conference and which are probably all going to be on our radar screen in the months ahead.

DJ Wilson - Host, State of Reform

1. The exchange is an embarrassment, but what if..?

Few folks thought the federal insurance exchange would be a smooth ride.  Not many thought it would be this bad, however.  Case in point:  Sen. Murkowski couldn’t find a single online enrollee as of mid-month.

It makes us wonder:  given the poor performance of the federal government, what if this had been managed in Alaska, by Alaskans?  Even rock solid conservative states like Idaho recently moved to a state-based exchange.  How about an Alaska-based state exchange in 2015?  It might make some sense, but given the governor’s position on this, I don’t see it happening.

2. “Who will take the consolidation lead?”

During our October conference, there was some significant hallway talk about Southeast Alaska, and whether hospital consolidation may be on the horizon there. With the context of the recent experiences at Bartlett and “Wrangell“, the question was “who will take the consolidation lead?”

According to the informal discussions at our event, SEARHC faced financial challenges, as a result of the sequester and even prior to that.  PeaceHealth was recently awarded the administration contract at Wrangell, adding to its long-standing presence in Ketchikan, but has its own cost pressures.  Providence seems capable, but a little far afield in Anchorage and Seattle, according to the folks we heard.

Keep your eye on this question to see what unfolds.

Premera Alaska Logo


3. Medicaid expansion gets significant support

The Alaska Chamber of Commerce made Medicaid expansion one of its top legislative priorities for the 2014 session.  That’s a significant political statement, and reflects the long, careful work by ASHNHA and ANTHC to build the case for expansion.

“Alaska businesses and individuals will be paying for the care for the uninsured in other states rather than in Alaska” unless Medicaid is expanded here, said Rachel Petro, President of the Chamber.

The governor is collecting agency request budgets now to support the development of his budget to be announced in December.  That is the next point at which the governor may address the policy question of expansion.

4. “We need to keep an eye on her…”

Commissioner Becky Hultberg offered the morning keynote at this year’s event, and succeeded in impressing practically everyone in the room.  Her slide deck was one of the most requested follow up items we received.

She was most noteworthy, however, not because of the content she provided, though the notion of ‘putting steerage on the table’ for employee and retiree benefits certainly got folks’ attention.

Instead, folks we heard from appreciated the data-driven, apolitical approach to health policy that seems so lacking these days.  People said they wanted to “keep and eye on her” not because of her content, but because they said they hoped to see more of her in Alaskan politics in the years to come.



5. State health IT implementation has a few bumps, too

The federal government isn’t the only government going through a tricky healthcare IT implementation.  On October 1, the State of Alaska was implementing a series of new IT systems, including an upgrade to their 25 year old Medicaid IT system.

The project has been envisioned for a while now, but even with the process starting in 2006, health IT implementation is just hard for everyone – whether that’s in the public or private sector, or whether that’s the federal exchange or state Medicaid.