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Alaska Primary Care Association December 3, 2015 THE HEALTHY ALASKA PLAN

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(1)

THE HEALTHY ALASKA PLAN

(2)

The Healthy Alaska Plan 2

HEALTHY ALASKA PLAN

AGENDA

Healthy Alaskans

Medicaid Expansion Update

Catalyst for Reform

Medicaid Redesign & Expansion Technical Assistance Contract

1915 (i) and (k) Contract

(3)

The Healthy Alaska Plan 3

HEALTHY ALASKANS

Who is covered by expansion?

Adults Ages 19 – 64

Not otherwise eligible for Medicaid or Medicare

Earning up to 138% of the Federal Poverty Level (FPL)

Single adults earning up to $20,328 per year

$1,694 per month

Two-person family earning up to $27,492 per year

(4)

The Healthy Alaska Plan 4

HEALTHY ALASKANS

How many have signed up?

Estimates for year one = 20,666

As of November 30th:

5,685 determined eligible for Medicaid Expansion

Chronic & Acute Medical Assistance enrollees

transitioned to Medicaid

(5)

12/8/2015 The Healthy Alaska Plan: Medicaid Expansion in Alaska 5

HEALTHY ALASKANS

Where can people apply?

Apply one of the following ways:

www.healthcare.gov

“No Wrong Door”

ARIES Self Service Portal

Uses your myAlaska Account

Paper application

(6)
(7)

CATALYST FOR REFORM

The Healthy Alaska Plan 7

Medicaid Redesign & Expansion Technical

Assistance Contract

Contract Awarded to Agnew::Beck

Subcontractors: Health Management Associates (HMA) and

Milliman (actuarial firm)

Contract Amendment: Additional Stakeholder Process

Sector engagement sessions

Alaska State Hospital & Nursing Home Association; Alaska Primary

Care Association; Long Term Service & Supporters Providers; Alaska

Behavioral Health Association; Physicians; Tribal Health

Organizations; Change Agent Conference

Webinars follow each Key Partners Work Session

Contract and Amendment are posted online

(8)

CATALYST FOR REFORM

Key Partner Organizations

The Healthy Alaska Plan 8

Alaska Association on Developmental Disabilities Alaska Behavioral Health Association

Alaska Commission on Aging Alaska Dental Society

Alaska Geriatric Exchange Network (AGENet) Alaska Legislature: House of Representatives Alaska Legislature: State Senate

Alaska Mental Health Trust Authority Alaska Native Health Board

Alaska Native Tribal Health Consortium Alaska Nurse Practitioner Association Alaska Nurses Association

Alaska Osteopathic Medical Association (invited)

Alaska PCA Association

Alaska Pharmacists Association

Alaska Primary Care Association Alaska Psychological Association

Alaska State Hospital & Nursing Home Association Alaska State Medical Association

American Academy of Family Physicians American Academy of Pediatrics (invited)

American College of Physicians

American College of Emergency Physicians Community Care Coalition

Governor's Office

Governor's Council on Disabilities and Special Education

Lt. Governor's Office

Mat-Su Health Foundation

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CATALYST FOR REFORM

Meetings Held: 1

st

Session

The Healthy Alaska Plan 9

July 27: Kick-Off Webinar

August 18: Key Partners Work Session

September 2: Project Update Webinar

Draft Environmental Assessment

Alaska’s current system

Models of care; provider reimbursement

Medicaid financing mechanisms to support systems change

Brainstormed shared vision and priorities for Medicaid

redesign

(10)
(11)

CATALYST FOR REFORM

Meetings Held: Round 2

The Healthy Alaska Plan 11

October 9: Key Partners Work Session

October 21: Project Update Webinar

Review of Initiatives

Alternative Models for the Expansion Population

Medicaid Reform Initiative Options

Evolving working document

Description; key features; federal requirements; IT needs;

rate structure and/or payment mechanism; statutory

(12)

CATALYST FOR REFORM

Reform Initiatives: All Presented

(13)

CATALYST FOR REFORM

Meetings Held: Round 3

The Healthy Alaska Plan 13

November 10: Key Partners Work Session

Presentation on Actuarial Analysis

Overview of the Approach

Review of Medicaid Reform Initiatives

Potential alternative coverage models for expansion

population

November 19: Project Update Webinar

(14)

CATALYST FOR REFORM

Reform Initiative: 2

nd

Review

(15)

CATALYST FOR REFORM

Preliminary Package of Reforms

(16)

CATALYST FOR REFORM

Remaining Work

The Healthy Alaska Plan 16

Actuarial Analysis and drafting the Final Report

DHSS will continue presentations as requested

January 15: Final Report due to DHSS

Contractors will be available for four legislative hearings

(17)

The Healthy Alaska Plan 17

Building

Reform.

Continuing

the Dialogue.

(18)

CATALYST FOR REFORM

More reforms to come

The Healthy Alaska Plan 18

1915 i/k Implementation Contract

Contract Awarded to Health Management Associates

Alaska currently provides HCBS to 4,000 individuals

under four 1915(c) Medicaid waiver programs:

Children with Complex Medical Conditions (CCMC)

Adults with Physical and Developmental Disabilities (APDD)

Alaskans Living Independently (ALI)

Individuals with Intellectual and Developmental Disabilities

(IDD)

(19)

CATALYST FOR REFORM

More reforms to come

The Healthy Alaska Plan 19

1915 i/k Implementation Contract

1915(i): For people who do not meet nursing level of care,

but meet other criteria

Alzheimer’s, traumatic brain injury, severe mental illness, or

individuals with developmental or intellectual disabilities

Section 1915(k) improve savings on home and

community-based services

Implementation: July 1, 2017

Stakeholder Process

“Development and Implementation Council”

In person forums: Anchorage, Barrow, Bethel, Fairbanks,

Mat-Su Valley, Juneau, Kenai, Ketchikan, Nome

(20)

CATALYST FOR REFORM

More reforms to come

The Healthy Alaska Plan 20

Provider Tax Study

Feasibility Study & Recommendation

Contract Awarded to Myers & Stauffer

No tax can be imposed without legislation

Every state in the union, except Alaska, has one or more

health care provider taxes

19 classes of health care services and providers can be

taxed

Nursing facility services and inpatient hospital services are most

common taxed classes

(21)

CATALYST FOR REFORM

Provider Classes Currently Under Study

(As of December 1st)

The Healthy Alaska Plan 21

1. Inpatient hospital

2. Outpatient hospital

3. Nursing facility

4. Intermediate care facility services

for individuals with intellectual

disabilities

5. Physician services

6. Home health services

7. Outpatient prescription drugs

8. Services of managed care

organizations

9. Ambulatory surgical center

services

10. Dental services

11. Podiatric services

12. Chiropractic services

13. Optometric/Optician

14. Psychological services

15. Therapist services

16. Nursing services

17. Lab and x-ray services

18. Emergency ambulance services

19. Other:

RPTCs

PCAs

HCBS Waiver

(22)

CATALYST FOR REFORM

How can you stay informed?

The Healthy Alaska Plan 22

Healthy Alaska Plan

dhss.alaska.gov/healthyalaska

1915 i/k Implementation

dhss.alaska.gov/dsds/Pages/CFCcouncil/CFCDIC.aspx

Sign up for Email Updates

Request a presentation

(23)

Questions?

Thank you!

Monique Martin

monique.martin@alaska.gov

269-7848

References

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