Preserving Medicaid to improve the health of our citizens

The Mat-Su Health Foundation (MSHF) has three advocacy priorities related to the proposed FY20 State of Alaska budget: preserve funding for Medicaid, early childhood education, and housing and homelessness programs. While our work touches many agencies and institutions affected by the budget, we’ve prioritized where AK needs to continue to invest to improve the health of our citizens, build out critical healthcare infrastructure, leverage federal dollars, and increase private sector jobs and investments.

In the 2013 Mat-Su Community Health Needs Assessment, Mat-Su residents ranked alcohol and drug abuse as the number one health issue facing our community, followed by other Behavioral Health (BH) problems like child maltreatment, domestic violence, depression and access to mental healthcare. Since then, through a strengthened Medicaid program, MSHF has worked with the State and other partners to fill gaps and increase access to BH services in more cost-effective settings right here in Mat-Su. These include residential treatment for women, peer support and recovery services, and a variety of children’s mental health services. We’ve been able to guarantee pre-treatment services, including a Substance Use Disorder (SUD) assessment, within 24 hours to those ready to seek treatment. We’ve reduced Emergency Department (ED) utilization by 61.7% in a cohort of 60 ED super-utilizers in the first year of a pilot project and saved payors, including the State, $1,141,493.

Major private sector investments are happening in Mat-Su to build new infrastructure and create private sector jobs for badly needed BH services. Mat-Su Regional Medical Center (MSRMC) and MSHF responded to our community’s opioid and BH crisis by planning to invest $18.5 million in 2019 and 2020 in a BH wing and Psychiatric ED. These services rely on Medicaid funding to operate. The uncertainty created by the Phase I cuts and FY20 budget in the first year of a new administration has investors reeling and questioning these and future investments.

The proposed Medicaid cuts also impact older Alaskans. In the 2016 Mat-Su Senior Environmental Scan, we documented that from 2015 to 2020, the borough’s senior population would grow by nearly 41%, far outpacing national growth of a mere 18%. The age 65+ and 75+ population cohorts were projected to grow 114.3% and 201.5% by 2030 respectively. Mat-Su will need significantly more Assisted Living Facility (ALF) services, particularly memory-care, which will require three times as many beds in 2030 as were needed in 2015. Once again, private enterprise is responding to this need by investing in building Skilled Nursing Facility (SNF) and ALF beds in Wasilla and Palmer and creating new private sector jobs. However, many patients who need these services rely on Medicaid to pay for them. Once again, Medicaid is a key payor to create these private sector jobs, meet market demand, and guarantee dignified care for our elders.

Let’s preserve Medicaid and continue to reform it. And Medicaid Reform is working. According to data from the Department of Health & Social Services (DHSS), $140 million in State general fund savings and cost avoidance were achieved in FY 2018, and State spending on Medicaid has remained almost flat since 2012. Increases in enrollment have led to increases in spending, but this has been almost entirely covered by federal dollars. Alaska currently covers 79,000 more enrollees using 11% fewer State dollars than it did four years ago.

DHSS Commissioner Adam Crum has relayed that the Governor’s main health goals are to reduce healthcare costs to the State and reduce healthcare costs for Alaskans. Like the Governor, private and public funders, including MSHF, want to ensure our dollars are used prudently, with maximum administrative efficiency, and that those dollars produce the desired outcomes. The Foundation stands ready to partner with the administration and legislature to support meaningful, manageable Medicaid reform that makes good use of State dollars while also improving the health of our residents and the critical healthcare infrastructure that supports a healthy community and economy. With 31,592 Mat-Su residents receiving health coverage through Medicaid, this program is vital to ensuring almost one third of our populace has an opportunity to live a healthy life.

Mat-Su Health Foundation is the official business name of Valley Hospital Association, Inc., which shares ownership in Mat-Su Regional Medical Center (MSRMC). MSHF actively participates in the governance of MSRMC and protects the community’s interest in this important healthcare asset through board oversight. MSHF invests its share of the profits into charitable works that improve the health and wellness of Alaskans living in the Mat-Su. More information is available at www.healthymatsu.org.