Alaska’s Department of Health and Social Services (DHSS) recently published the report “Alaska State Health Care Environment 2015”. According to the report, HRSA in 2015, awarded New Access Point Grants to additional clinic sites which brings Alaska’s total FQHCs to 29 managing organizations and 168 clinic sites.
New state legislation was not passed regarding telehealth during the 2015 legislative session but still telehealth was an area of focus. Discussion took place concerning proposed changes in Medicaid reform, Medicaid expansion, healthcare delivery, and cost containment as related to the use of telehealth. Primary care, behavioral health, and urgent care were specific areas of interest in considering the expansion of telemedicine.
On July 16, 2015, Governor Bill Walker announced that he would accept additional federal and Alaska Mental Health Trust Authority funds to expand Medicaid in Alaska. It is anticipated that the expansion will bring $146 million to the state in the first year and extend coverage to well over 20,000 people.
DHSS is working on initiatives to improve fraud and abuse controls, provide for pharmacy reform and care management, and address the increase in emergency room services. DHSS has hired a contractor to provide technical assistance and support for Medicaid expansion and redesign.
The contractor with feedback and assistance from stakeholders across the state will conduct a Medicaid Reform Environmental Assessment that will provide an analysis of national factors impacting Medicaid programs.
The contractor will assemble a report on “Recommended Medicaid Expansion and Reform Strategies for Alaska” to be presented to the 2016 Alaska Legislative Session. The final strategy will include a three year action plan to implement and evaluate the recommended expansion models and reforms.
Alaska has been active in recognizing 18 organizations in the state that are recognized as Patient Centered Medical Homes (PCMH). This includes projects such as the Alaska Patient Centered Medical Home Initiative, Tri-State Children’s Health Improvement Consortium (TCHIC), and the Pediatric Medical Home D70 State Implementation Grant.
Beginning on October 2014, CMS changed their payment methodology for Medicare claims for FQHCs transitioning to a prospective payment systems in which Medicare payment is made based on a predetermined fixed amount. All health centers are to transition to this new system by December 31, 2015.
Sources of care for rural veterans in Southeast Alaska are provided through the Rural Veterans Health Access Program (RVHAP) funded by HRSA’s Office of Rural Health Policy and administered by the State Division of Public Health.
The RVHAP provides telebehavioral health and teleprimary care at some sites for veterans and their families in remote areas. So far, there are four partnering agencies with a total of seven service sites. Teleconnectivity for video-linked consults have been established in all seven sites and services are available with links to clinicians in the hub communities of Juneau, Wrangell, and Sitka.
The RVHAP also sponsored a series of educational webinars in August 2015 for medical and behavioral health clinicians and the public on traumatic brain injury and for community members on first responder suicide prevention.
The “Alaska State Health Care Environment 2015” report is available at http://dhss.alaska.gov/dph/HealthPlanning/documents/primarycare/state%20Health%20Care%20Environment.2015.pdf.