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Health Care Report Calls for Payment Reform in Alaska

Panel Created by Begich Also Highlights Workforce Needs

A task force created by U.S. Sen. Mark Begich is recommending a new payment structure for Alaska doctors reimbursed by federal agencies, which are the main source of health care for more than half of all Alaskans. A higher payment structure for Alaska would incentivize doctors in Alaska to treat patients covered under federal health care programs.

The report of the Alaska Health Care Task Force was submitted by U.S. Health and Human Services Secretary Kathleen Sebelius to House and Senate leadership last Friday. The task force was established by a Begich amendment to the new health reform law.

"This report is good news because it confirms to the federal agencies and Congress what Alaskans have known for years - our cost of health care is enormous and still growing," Begich said.  "The next step is to turn this into action, make sure doctors and other providers are fairly compensated and see that Alaskans have access to quality, more affordable health care."

Begich said he appreciates the commitment of the task force and will use its findings to work with the agencies on health care improvements in Alaska. If needed, he will turn to his Congressional colleagues for legislation and appropriations. For instance, Begich will ask federal agencies to provide more detailed recommendations on payment reform, such as suggested reimbursement rates.

Under his amendment the task force was terminated when it filed its report, but many of the highlighted issues are ongoing topics in the agencies.

The task force was comprised of top officials from all departments providing health care in Alaska: Department of Defense, which provides TRICARE for active duty military members, military retirees, and their families; the Department of Veterans Affairs and its Veterans Health Administration (VHA); the Indian Health Service (IHS); and the Centers for Medicare and Medicaid Services. The task force held meetings in Washington, D.C., and Alaska. In August, the task force made site visits to Soldotna, Fairbanks, Galena, Nome and Anchorage.

The report highlights the significance of federally-provided health benefits in Alaska. "Slightly over 50 percent of the state's residents receive health care paid primarily by the federal government," the report says.

That includes an estimated 138,000 IHS patients, 125,000 Alaskans on Medicaid, 75,000 receiving TRICARE, 64,000 seniors on Medicare, and about 15,000 veterans getting VHA services. In some cases Alaskans are eligible for more than one type of federal coverage.

Other recommendations address workforce and training issues, including the need for more medical education residency slots in Alaska and reciprocity agreements with other states to grant medical licenses more quickly in Alaska. Also highlighted is both the progress and ongoing need for health information technology throughout the state.

Another recommendation urges federal agencies to coordinate existing Internet portals into a single point of entry for Alaskans trying to determine their eligibility for health care coverage.

On payment reform, the report calls for uniform reimbursement rates for similar medical services provided under Medicare, TRICARE and the VA. Currently, Medicare is the lowest payer amongst all health coverage providers in Alaska, which has resulted in some doctors closing their doors to new and - in some cases - existing Medicare patients. The report also praises new payment models in the health reform law and calls for coordination among federal agencies regarding medical transportation costs in Alaska.

It suggests the need for improved state and federal cooperation when addressing the health needs of Alaskans.

"The state has made great progress in setting its own agenda for change by defining the problems it faces ... but many of their long-term goals depend on cooperation by the federal agencies with health responsibilities in the state."

The task force was chaired by Marilyn Tavenner, former Secretary of Health and Human Services in the State of Virginia and now principal deputy administrator in CMS. The full report is available online at: http://begich.senate.gov/public/index.cfm?p=HealthCare

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