A new report commissioned by Alaska legislature dismisses some of lawmakers' challenges against Medicaid expansion, which went into effect last year when Gov. Bill Walker (I) overrode legislature and expanded Medicaid on his own, according to the Alaska Dispatch News.
The report was conducted by Virginia-based health policy consulting firm, the Menges Group.
Among the findings from the report are:
1. The Menges Group found no evidence expansion states have seen a reduction in the need to maintain current budget levels for disproportionate share payments to hospitals.
"Phasing down of even the federal disproportionate share payments to hospitals, which were slated to occur as large numbers of previously uninsured persons moved into Medicaid coverage, has been postponed. While redeployment of funds to serve additional persons broadens the sphere of persons benefiting from public support, such dynamics cannot be appropriately referred to as 'savings' being created by Medicaid expansion," the Menges Group wrote.
2. The Menges Group's analyses of the enrollment trajectory of states that have and have not implemented Medicaid expansion suggest there is likely a "woodwork" effect — where people come "out of the woodwork" and obtain Medicaid coverage they would not otherwise have obtained — increasing the volume of people on traditional Medicaid coverage related to the Affordable Care Act overall, but there isn't such an impact directly attributable to expanding Medicaid.
3. Concerns were raised that providers will see a greater proportion of low-payment patients under Medicaid expansion and in some cases render provider practices non-viable. The Menges Group found while data evidence on this particular issue is sparse, they have not been aware of situations where providers have been harmed by Medicaid expansion. To the contrary, Medicaid expansion brings a large infusion of new revenue to the provider community, the Menges Group said.
4. According to the Alaska Dispatch News, the total state cost of expansion in Alaska will hit $24 million by 2020, but the Menges Group said there are "large-scale opportunities" to cut spending for Medicaid over the long-term to offset the increased costs.
A second report submitted to Alaska's Department of Health and Social Services by Agnew::Beck Consulting recommends larger structural changes to Medicaid that state health officials hope could ultimately result in cost savings, according to the Alaska Dispatch News.
Among the recommendations are:
5. An initiative that would pay primary care providers a $5 monthly per-patient fee to coordinate care for Medicaid recipients. Those with chronic conditions and bigger health problems would be referred to more intensive programs, the consulting firm's report said, according to the Alaska Dispatch News.
6. According to the Alaska Dispatch News, there is also a recommendation to create a new data analytics program to link hospitals, emergency departments, local physicians and prescription drug database into a "single repository."
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