AK: Behavioral health lagging

Alaska’s behavioral health providers are still struggling to serve Alaska’s more vulnerable, and costly, populations. Recent presentations from the Alaskan Behavioral Health Association (ABHA) and the Mat Su Health Foundation (MSHF) have highlighted stagnant Medicaid rates for providers eligible to receive it, while arguing that state-only funding for services is insufficient to meet the need.

ABHA slide

Source: Alaska Behavioral Health Association

Funding issues

According to the ABHA, Medicaid accounts for 48 percent of BH provider revenues, while 20 percent are covered by state funded grants. Medicaid reimbursement rates for behavioral health services have not been adjusted since 2009. Governor Walker’s legislation to expand Medicaid sought to gradually address these deficiencies, shifting more behavioral health funding from state funds to Medicaid while re-basing the Medicaid rate structure for behavioral health services. Since that plan has been taken off the table for at least the near future, providers will likely have to continue to live with the current reimbursement structure.

Slow to endorse expansion

A portion of the behavioral health community was slow to get on board with the Governor’s Medicaid plan. In March, the Governor released a list of 56 organizations that had endorsed Medicaid expansion. That list was missing the state’s largest behavioral health providers and associations.

Since, the list has since grown to over 100 organizations, including the ABHA, North Star Behavioral Health and South Peninsula Behavioral Health Services. The reasoning behind the delay is unclear, but notable given the boost expansion would have provided for Alaska’s behavioral health community.

Mat Su Slide

Source: the Mat Su Health Foundation

Urgent need, inadequate response

According to the Mat Su Health foundation, suicidal ideation is the top BH diagnosis for children under 18, while substance abuse disorder is the top diagnosis for those between the ages of 18 and 64.

Anxiety disorders are the top diagnoses for older Alaskans. Providers are reporting up to a six month wait for those in need of services, which they explain is a critical gap.

When talking to providers about barriers faced by behavioral health in Alaska, a theme brought up frequently is a culture among some in the legislature that discounts behavioral health.

A re-prioritization, via Medicaid expansion or otherwise, may be necessary to deal with the challenges Alaska’s behavioral health community is facing for the years ahead.