Alaska’s second Medicaid redesign meeting has stakeholders lukewarm

The second of five stakeholder meetings to lay the groundwork for Alaska’s Medicaid Redesign and Expansion Technical Assistance Project was held on Oct. 9. The Department of Health and Social Services (DHSS) and its consultants invited one representative from each stakeholder group to participate in a discussion of proposed initiatives and a timeline for the Healthy Alaska Plan. Some stakeholders found that the proceedings fell short of the mark.

“While this is the most detail available to date, many initiatives still lack sufficient information on which to judge them,” wrote Becky Hultberg, President and CEO of Alaska State Hospital and Nursing Home Association (ASHNHA) in her weekly update. “The four hour stakeholder session was not sufficient time to vet, prioritize and select among the options (and not enough stakeholders were in the room). It’s not clear how the consultant will be soliciting feedback moving forward.”

Below is a high-level timeline presented by DHSS which envisions “new models of care” by 2018.

AK Medicaid timeline

Alaska Medicaid timeline presentation by DHSS at the Oct. 9 stakeholders’ meeting. / Source: ASHNHA

Stakeholders were asked for feedback in defining initiatives to push forward for policy and actuarial analysis. A lengthy list of initiatives were presented at the meeting:

Delivery System Reforms

  • Wellness & prevention initiative for all enrollees
  • Primary care improvement initiative
  • Behavioral health and primary care integration initiative
  • “Emergency room is for emergencies” initiative
  • Accountable Care Organization (ACO) demonstration

Expansion Models

  • Wellness benefit package
  • Shared responsibility benefit package
  • Minimum essential benefit package
  • Private insurance option

Payment Reforms

  • Bundled payment demonstration
  • Pre-paid Ambulatory Health Plan demonstration
  • Pre-paid Inpatient Health Plan for Critical Access hospitals
  • Full-risk managed care

Infrastructure Improvements

  • Telemedicine
  • Medicaid business process improvement
  • Data analytics and IT infrastructure

Stakeholders were tasked with the critical task of providing feedback that will eventually shape and prioritize this list into “actionable items.” DHSS will hold its third stakeholder meeting on Oct. 21.