As State of Reform continues to expand and grow, we’re excited to announce that we’ve hired a new full time reporter to cover the intersection of health care and health policy in Alaska. Shane Ersland comes to State of Reform with over 10 years of journalism experience, having most recently worked as an editor at the Yakima Valley Business Times in Washington State.
You can reach out to Shane with tips and story ideas here!
State of Reform
1. Reps. Fields & Prax discuss health policy priorities
During recent interviews with State of Reform, Reps. Mike Prax (R) and Zack Fields (D) discussed key health policy conversations taking place this year and highlighted their health policy priorities moving forward. The lawmakers discussed a range of issues including workforce, telehealth utilization, health funding in the budget, and the establishment of Crisis Now—a model that aims to improve Alaska’s behavioral health crisis system of care.
A key conversation this year, they agreed, was the governor’s executive order to restructure DHSS. Prax says the department split offers a chance to improve efficiency within the agency and potentially lower health care spending. Fields said he would have preferred to include more stakeholder engagement in the conversation, but says he hopes the transition is able to occur smoothly and without financial hiccups or disruptions to services.
2. Lawmakers debate behavioral health bill
In recent weeks, the Senate Health and Social Services Committee held a series of meetings to discuss amendments to SB 124, a piece of legislation that aims to build out Alaska’s behavioral health continuum of care. Among several provisions, the bill looks to create a “no wrong door” approach to behavioral health crisis care, expand the number of facilities that can conduct 72-hour evaluations, and add a new, less restrictive level of care.
At the end of March, lawmakers voted down an amendment that would have included transportation time in the 72-hour evaluation period. They approved an amendment that requires family members be notified when an individual is admitted to a crisis stabilization or residential center, but voted against another that would have changed the “probable cause” language used in the bill. SB 124 was referred to the Senate Judiciary Committee on Friday.
3. Health leaders discuss workforce shortage
During a recent meeting with lawmakers, three health care organizations discussed the current state of Alaska’s health care workforce shortage and described the outlook for the industry over the next decade. A recent ASHNHA analysis found that jobs in the state’s health care industry are expected to grow 7.6% over the next 10 years—creating a projected 5,000 new jobs. The greatest workforce needs, according to the report, are for registered nurses, medical assistants, nursing assistants, and home health aides.
During the meeting, Providence Alaska CEO Preston Simmons said Providence currently sees 25% fewer applicants than it did in 2019. It has a vacancy rate of 16.7% and there are 782 open positions. Foundation Health Partners CEO Shelley Ebenal said their employee turnover is currently at 30%—the highest it’s been in 20 years. “The takeaway you need to know is developing the talent pipeline for the health care workforce is one of the best investments we can make for Alaska,” said ASHNHA CEO Jared Kosin. “Our pipeline is underperforming so severely, we really can only go up.”
4. Alaska sees spike in overdose deaths
Alaska saw a 68% increase in drug overdose deaths between 2020 (146 deaths) and 2021 (245 deaths), according to the latest information from DHSS. The increase is largely driven by fentanyl in Alaska, where 6 out of every 10 drug overdose deaths involve the powerful opioid.
Seth McMillan, a member of the Anchorage Police Department’s SWAT/FBI Safe Streets Task Force, offered an update on Alaska’s street drug challenges during a recent DHSS meeting. He reported that the state’s crack cocaine use is now increasing (after decades in decline), heroin and methamphetamine use is high, and that the use of heroin mixed with fentanyl is out of control. “Between that and methamphetamine, they’re in a fistfight to try to destroy Alaska,” McMillan said.
5. Inflation’s impact on Medicare
The most recent consumer price index revealed an 8.5% annual rate of inflation between March 2021 to March 2022. “If such rapid price escalation persists for an extended period, it will have broad implications for many federal programs, including Medicare,” says State of Reform Columnist Jim Capretta in his latest column.
High rates of inflation impact the Medicare program in several ways through changes to CMS’s “market baskets,” through real cuts in physician fees, and to Medicare Advantage rate changes, writes Capretta. “For 2023, CMS already has announced a growth rate of 4.88%. Together with other trends and modifications, CMS expects the average payment for MA enrollment to grow by 8.5% in 2023.”