State of Reform: 5 Things We’re Watching Alaska

After our September conference, one thing we heard over and over again was “It’d be nice if you could keep us in the loop when some of this stuff comes together.”

We heard you.  So, we’re proud to launch our “5 Things We’re Watching” newsletter as a result.  This will only come once a month – we don’t want to fill up your inbox with junk.  We’ve hired a part-time Anchorage-based analyst to cover issues on the ground, as well.

We’re all trying to track so many things – here are five on our radar screen.


1.The Supreme Court.  Wow.

We followed closely all 6 hours of testimony during the hearing and posted on it (here, here, here and here).  If you didn’t listen in detail, we can tell you this: it was even worse for the administration than the reports made it out to be.  Now folks are turning to the question of “What if the Court throws the ACA out? Or just part of it?”

We’re working on an answer actually – a series of them, to be honest called “What If?”  But until then, here are two must reads that might have gotten overlooked:  Ungar, and Toobin.

2.Premera innovates in the small group market

We host State of Reform in 4 states, and we work with providers in 7 states.  We’re familiar with a lot of different approaches to “innovation” – some real, and some more talk.

In Alaska, where “cost” is the topic on everyone’s mind, Premera is legitimately changing the game in perhaps the hardest part of the market to innovate – the small group market.


3.What’s the Commission have planned for 2012?  

Last year’s Health Care Commission report on rates (or costs, depending on your perspective), garnered a lot of attention.  A 3-part series of stories by Alaska Public Radio brought the issue to the fore of the public’s mind.

Given that power to shape public awareness, what will the Commission be working on this year?  We went straight to source in an interview with Commission Executive Director Deb Erickson.

4.Speaking of Milliman’s rate study…

It’s worth revisiting the Milliman rate study on occasion to relearn the lessons learned there.  On the one hand, Alaska Medicaid rates are 174% of the 6-state combined average.  On the other hand, that rate only increased 3% from 2003 to 2008, the 5th lowest inflation rate in the country.

That said, not all things Milliman says can be trusted – that’s according to one of Milliman’s former lead consultants in a letter released this week as part of a legal matter against the State of Washington.

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5.New strategies for public health care dollars  

Last week’s deadline for the state RFP for a “Health Management and Health Plan Design Consultant” had health care insiders we talked to abuzz.  Government officials hoped there might be an opportunity to take dollars out of agency silos to find new efficiencies.  Private sector folks hoped this was a sign of new ambition on the part of state government.

Whatever comes of it – and it looks to be a positive sign – state government will have to walk before it can run.  Ask the University of Alaska, which endured premium increases of over 250% with a new benefit model, or the ODS Health Plan, which has an MLR of over 100% in Alaska.