February 22, 2013

Legislative Notes for ASHNHA members; compiled from hearings, reports, news accounts and good old fashioned face to face discussion in the Capital City

Alaska Facilities Await Word on Sequestration—Big Impacts on March 1

Only one week remains until the automatic federal spending cuts, known as sequestration, occur.  
Unless there is a last minute federal deal by March 1 to avoid these spending cuts, they will total $1.2 trillion over the next 10 years (half of which will come from domestic discretionary spending).  According to the non-partisan Congressional Budget Office, the cuts could result in 750,000 job losses by the end of this year.

The 2% "sequestration" cut, if imposed, would be a reduction in any check the feds cut to Medicare providers. The 2% cut only applies to Medicare provider payments; it does not apply to Medicare benefits or Medicaid.
Specific to health care, the 2 percent cut to Medicare providers and insurer payments would eliminate $100 billion in Medicare spending over 10 years, including $3 billion in the current fiscal year.

ASHNHA has recently conducted an analysis of budget impacts of Congressional mandated cuts to Medicare. In Alaska, the 2 percent cut to Medicare would mean $56.7 million in cuts in Medicare spending in Alaska over 10 years, including $5 million in the current fiscal year. 

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ACA and Other Congressional Cuts Add up to Real Money

A new analysis by Data Gen (see figure in above article “Alaska Facilities Await Word on Sequestration—Big Impacts on March 1”) shows Alaska will take significant reductions in Medicare reimbursement between 2013-2022.  All cuts combined that are already in law account for a 9.2% reduction in Medicare spending to Alaska facilities over that period.  The cuts from the ACA alone account for over $200 million.  As the American Hospital Association continues to remind policymakers—hospitals took those cuts under the rationale that coverage expansions would compensate for such cuts.  At that time that deal was struck, the Medicaid expansion was not optional.

Webinar - DataGen Medicare Analytics - 2/28/13 10 am
A webinar is scheduled with DataGen to review the analytic reports provided to ASHNHA and Alaska hospitals. A variety of analyses will be available during 2013 including regulatory, quality/finance and legislative.

Topic: ASHNHA Medicare Analytics
Date: Thursday, February 28, 2013
Time: 10:00 am, Alaska Standard Time
Meeting Number: 717 082 945
Meeting Password: Alaska1
To start or join the online meeting click here
If you have specific questions about any of the reports email Jeannie Monk in advance so we can ensure they are addressed during the webinar.

ASHNHA Legislative Fly-In Well Attended

Senator Kevin Meyer, Co-Chair of the Senate Finance Committee was the keynote speaker during dinner at the Baranof.  He is pictured here speaking with Sean McCallister (Providence) and ASHNHA President Annie Holt (Alaska Regional).

Legislative Briefing by ASHNHA Lobbyists

ASHNHA Lobbyists Kent Dawson and Pat Carter discuss the current legislative climate and give updates on bills that may affect hospitals and nursing homes in Alaska.

What Medicaid Expansion Means for Alaska

Jay Livey from Alaska Native Tribal Health Consortium spoke on the recently released ANTHC Medicaid Reports.  His presentation titled, “Medicaid Expansion under the Affordable Care Act” led to a dynamic discussion on how Medicaid Expansion could affect Alaska hospitals and nursing homes. See the ASHNHA website for Jay’s powerpoint slides and the ANTHC reports.

Bob Letson Honored as the AHA's "Grass Roots Champion" for his Leadership at South Peninsula Hospital

Dale Kirby from the American Hospital Association (AHA) presented Bob Letson with the Grass Roots Champion award during the ASHNHA dinner. Dale remarked, “The AHA’s Grass Roots Champion award is given each year to a healthcare leader who effectively and reliably delivers our collective message to elected officials, and who advocates tirelessly for the hospitals and patients they serve.  Given the significant amount of grass roots activity in which the hospital field was engaged in 2012, I’m sure that Karen and her team had a difficult time selecting just one “Champion.”  But there is but one champion to recognize this evening:  Mr. Bob Letson, CEO of South Peninsula Hospital in Homer, AK.”
Bob and the other states’ Grass Roots Champions will be formally recognized during the 8th Annual Breakfast of Grass Roots Champions on Tuesday, April 30, at the Washington Hilton as part of the 2013 AHA Annual Membership Meeting.  Bob will receive a complimentary annual meeting registration, travel costs to Washington, DC, and a two-night stay at the Washington Hilton.

Dinner Well Attended by Legislators

Legislators attended the Alaska Legislative dinner and a great time was had by all. We had a particularly strong showing from the Interior delegation. 

Pictured from left to right are Commissioner Streur, Senator Click Bishop, Senator John Coghill, Mike Powers (CEO Fairbanks Memorial), Representative Steve Thompson, and Senator Pete Kelly. 

Wrangell Medical Center Stabilizing with New Leadership

Woody Wilson, Wrangell Medical Center Board Chair (left) and Robert Honeycutt (below) from Providence Alaska Medical Center listens to Jay Livey’s presentation on Medicaid Expansion.

Marla Sanger (pictured right) is the interim CEO at Wrangell Medical Center.  Marla recently moved from Washington State where she worked for PeaceHealth. Ms. Sanger was most recently a Program Manager on a System Quality and Process Improvement Team.  

Wrangell Medical Center has a new Board and with that comes a significant amount of change. Marla and Woody reported the changes being made are having a positive impact both for staff and patients. The Wrangell Board is focusing on the health of the community and continuing the process to build a new facility. Marla commented, "A staff member came to show me the local paper's front page the other day -and I didn't know what I was looking at until the staff member said, 'the medical center isn't on the front page - the first time in many months!' And that was a positive thing to see."

ASHNHA Members Present to House Health & Social Services Committee

On February 19, ASHNHA members Mike Powers, Fairbanks Memorial Hospital; Dr. Andy Mayo, North Star Behavior Health; and Laurie Dotas, Prestige Care; presented to the House Health and Social Services Committee. The video of their presentation can be viewed ( it follows a presentation by Tribal Behavioral Health Directors) - click here to view the presentation. The presentation was titled “Overview of Alaska's Hospitals and Nursing Homes.” covering areas such as Alaska’s rural environment, health care workforce, the economic impact on the State, and an overview of each presenter’s facility. The slides from the presentation can be accessed at the following link or on the ASHNHA website.
We want to thank the presenters for their excellent overview of hospitals and long term care facilities in Alaska and representing the needs and demands of our industry. Pictured left to right: Representative Geran Tarr, Representative Pete Higgins, Laurie Dotas, Dr. Andy Mayo, and Mike Powers.

Physician Costs Continue to be Hammered

The Health Care Commission Chair Dr Ward Hurlburt and Commission Director Deb Erickson presented on the Commission’s work this week to the House Finance Subcommittee.
About half of the presentation was related to graphs showing the overall growth of health care in the nation and in Alaska with all graphs showing the same trend—a steep rise in cost. 

Like Commissioner Hultberg the week before, the presentation then turned to the 2011 Milliman Report data on physician costs in Alaska—actually using data that we believe has not been available to the public previously.  The presentation focused on two aspects—the difference in costs paid in Alaska versus comparison states and the difference between payers in Alaska.  (see charts below)

The presentation of these costs seems to be heading more and more to the sensationalistic-sort of data by PowerPoint rather than an overall factual description of pricing in the market.

Most of this seems to be heading to the price and transparency initiative that the Commission is working on—this next week they are going to release their study on the All Payer Claims Database.  Basically this is a database which collects the information from all payers-rather than providers- that can profile all manner of information on the health care system.  The Commission meets on March 7th and 8th in Anchorage to hear the feasibility report.

The Commission Director and Chair will also testify in House HESS next week on Thursday February 28th at 3:00pm.

Legislative Hearings for the Week of February 25-March 1st

Wednesday, February 27th @ 8:30am – House Health & Social Services Finance Subcommittee – Agenda to be announced
Wednesday, February 27th @ 1:30pm – Senate Judiciary – SB 49 Medicaid Payment For Abortions; Terms – Testimony by invitation only
Thursday, February 28th @ 8:00am – Senate Health & Social Services Finance Subcommittee – Other Issues within the HSS Budget followed by a Question and Answer session on any aspect of the budget
Thursday, February 28th @ 3:00pm – House Health & Social Services Committee –
Presentations by Alaska Health Care Commission
Friday, March 1st @ 8:30am – House Health & Social Services Finance Subcommittee – Budget Close out 

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