Legislature(2021 - 2022)SENATE FINANCE 532
04/29/2021 09:00 AM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| SB93 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 93 | TELECONFERENCED | |
| + | TELECONFERENCED |
SENATE FINANCE COMMITTEE
April 29, 2021
9:17 a.m.
9:17:26 AM
CALL TO ORDER
Co-Chair Bishop called the Senate Finance Committee meeting
to order at 9:17 a.m.
MEMBERS PRESENT
Senator Click Bishop, Co-Chair
Senator Bert Stedman, Co-Chair
Senator Lyman Hoffman
Senator Natasha von Imhof
Senator Bill Wielechowski
Senator David Wilson
MEMBERS ABSENT
Senator Donny Olson
ALSO PRESENT
Lori Wing-Heier, Director, Division of Insurance,
Department of Commerce, Community and Economic Development.
PRESENT VIA TELECONFERENCE
Nancy Giunto, Washington Health Alliance, Seattle, WA;
Elizabeth Ripley, President, Matsu Health Foundation,
Wasilla; John Freedman, President, Freedman Health Care,
Massachusetts; Fred Brown, Executive Director, Pacific
Health Coalition, Anchorage; Patrick Shier, Pacific Health
Coalition, Wasilla; Peter Hayes, Healthcare Purchaser
Alliance of Maine, Maine; Sandra Heffern, Effective Health
Design, Anchorage; Bethany Marcum, Alaska Policy Forum,
Anchorage.
SUMMARY
SB 93 HEALTH INS. ALL-PAYER CLAIMS DATABASE
SB 93 was HEARD and HELD in committee for further
consideration.
SENATE BILL NO. 93
"An Act relating to the establishment of an all-payer
health claims database; and providing for an effective
date."
9:18:31 AM
Co-Chair Bishop noted that SB 93 was being heard for the
first time. He expressed his intention to hear and hold the
bill.
9:19:29 AM
LORI WING-HEIER, DIRECTOR, DIVISION OF INSURANCE,
DEPARTMENT OF COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT,
discussed a presentation entitled "CSSB 93" (copy on file).
Ms. Wing-Heier looked at slide 2, "Health Care Quadruple
Aim," She commented that the topic of the cost of health
care had been a focus of the legislature and the
administration for years. She shared since 2014, when she
became director of the insurance division, there had not
been a legislative session in which discussions had
occurred, or bills had been introduced, to address the
concerns of the costs and access to health care. She
observed that there were 56 bills related to health care
currently at play during the legislative session. She spoke
the slide and of the quadruple aim of the health care
community: improved patient experience, better health
outcomes, lower cost of care, and improved staff
experience. She relayed that two of the sections of the
quadruple aim, better health care outcomes and lower cost
of care, could be addresses with an all-payer claims
database. She said that the other two the patient
experience and the provider experience, could be addressed
in time.
9:21:22 AM
Ms. Wing-Heier spoke to slide 3, "Broad Community
Involvement":
?Administration and the Legislature
?Congressional delegation
?Tribal partners
?Chamber of Commerce and other business organizations
?Alaska Healthcare Transformation Project
?Alaskans for Sustainable Healthcare Costs
?Alaska Policy Forum
?Mat-Su Health Foundation
?Municipalities, School Districts, and Universities
?Insurance companies and insurance brokers
?Providers
Ms. Wing-Heier said that discussions had occurred among a
broad range of health care community members.
9:22:03 AM
Ms. Wing-Heier referenced slide 4, "What is missing?
Organized, succinct data":
Sources of Data
?AlaskaCare
?Medicaid
?Medicare
?Insurance Companies
?Third-Party Administrators
?Trusts and other Self-Insured Plans
Ms. Wing-Heier thought the bill would be a start in
beginning to address the cost of healthcare in an efficient
manner. She estimated that if the bill passed immediately,
it would be three to five years before data was available,
which meant that the longer the legislation languished, the
longer it would take to make improvements in health care.
She discussed the various data needed to assess health care
needs in the state and lamented that there was not one
depository for consolidating data.
9:23:10 AM
Ms. Wing-Heier turned to slide 5, "Many Reports No Data,"
which showed images of health care reports ranging from
2009 to 2020. She relayed that the state had spent
thousands of dollars over many years to study health care.
9:23:39 AM
Ms. Wing-Heier considered slide 6, "Alaska Health Care
Commission and others." She asserted that informational
reports on all fronts seemed to point to an all payer-
claims database. She stressed that the number one
constituent and consumer complaint was the cost and
affordability of health care in Alaska.
9:24:09 AM
Ms. Wing-Heier displayed slide 7, "What is an All Payer-
Claims Data Base?":
An All-Payer Claims Data Base (APCD) is a large
database that includes medical, pharmaceutical, and
dental claims. These databases are hosted, directly
or through a contract, by states.
Public (i.e. Medicaid) and private payors (i.e.
insurance companies and third-party adjusters) submit
the data, in a pre-determined standard format, to the
state.
Ms. Wing-Heier stressed that the data for the proposed
database was already in existence. She discussed the type
of data that the proposed aggregation would include. She
stressed that the data would not have personally
identifiable information. She noted that the format for the
data would be
9:25:46 AM
Ms. Wing-Heier highlighted slide 8, "Who has an established
APCD?" The slide showed a map of the United States colored
according to which states had adopted an all-payer claims
database or had expressed interest.
9:26:05 AM
Ms. Wing-Heier looked at slide 9, "If not now, when? If
not us, who?":
If we are to continue with our partners, towards the
Quadruple Aim of Health Care we need to take the
first step.
And the No Surprise Bill Act under the Consolidated
Appropriation Act of 2021 just gave us a gentle
nudge.
9:26:41 AM
Ms. Wing-Heier addressed slide 10, "2020 No Surprise Bill,"
which showed images of bill pages. She shared that the
Congressional delegation had been working to fix health
care.
9:27:02 AM
Ms. Wing-Heier advanced to slide 11, "What the No Surprise
Bill provides":
?Provides a structure to protect consumers against
surprise medical bills and determining out-of-network
provider payments including air ambulances
?Notice and consent provisions for balance billing of
non-emergency services by non-participating providers
at participating facilities
?Establishes requirements for provider directories
?Establishes a dispute resolution process for
uninsured
rovides guidance for continuity of care
?Requires insurers and other plans to have a price
comparison tool
?Modifies requirement on insurance cards
?Requires plans to provide an advance explanation of
benefits
?Encourages All-Payer Claims Databases and provides
grants up to $2.5 million to each state
Ms. Wing-Heier discussed the benefits under the No Surprise
Bill.
9:28:30 AM
Ms. Wing-Heier looked at slide 12, "An APCD provision in
the No Surprise Bill." She relayed that of the 5,500
pages, 15 pages referenced the APCD. She said that the U.S
Secretary of Labor would set the format for the APCD and
was the qualifying factor that the state would use to
receive the $2.5 million grant.
Co-Chair Bishop understood that the grant would come form
the U.S. Department of Labor.
Ms. Wing-Heier corrected that the grant would come from the
U.S Department of Treasury.
Ms. Wing-Heier showed slide 13, "APCD Grants - $2.5
million":
The state shall submit an application, containing such
information as the Secretary specifies including how
the state will ensure uniform data collection and the
privacy and security of data.
9:29:23 AM
Ms. Wing-Heier referenced slide 14, "Authorized Users":
An entity wanting access to the APCD, that has
received a grant, shall submit to the State APCD an
application for such access which shall include:
n the case of an entity requesting access for
research purposes a description of the uses and
methodologies for evaluating health system performance
using the APCD; and
?Documentation of approval of the research by an
institutional review board, if applicable for a
particular plan or research
?The entity shall enter into a data use and
confidentiality agreement with the state the
agreement shall include a prohibition on attempts to
reidentify and disclose individually identifiable
health information and proprietary financial
information
?If the entity is an employer, health insurance
company, third-party administrator, or health care
provider requesting access for the purpose of quality
improvement or cost-containment, a description of the
intended use of the data.
?Employers and employer organizations may request
customized reports, at cost, subject to the
requirements of privacy, security, and proprietary
financial information. ?The state shall make
available, to all eligible users, aggregate data sets
free of charge.
Ms. Wing-Heier noted that the data would be subject to
HIPPA compliance.
9:29:59 AM
Senator Wielechowski asked whether the grants being
provided would cover the costs of the health trust now and
into the future.
Ms. Wing-Heier requested further clarification of the
question.
Senator Wielechowski spoke to concerns that some costs
would be covered now, but that it was unclear whether costs
would be covered in the future.
Ms. Wing-Heier affirmed that the $2.5 million would not
cover costs into the future. She thought it would cost $10
million to $13 million to get the database started.
Senator Wielechowski discussed return on investment. He
thought the APCD had been implemented in the State of
Colorado, where he said information had been gathered but
nothing had been done to change behaviors that would lower
health care costs.
Ms. Wing-Heier stressed that she did not think the APCD was
a silver bullet but considered that the database would
allow for the identification of certain trends. She
believed that it might not bring the costs down by 20
percent but would allow the state to stabilize and examine
where dollars were spent. She thought subsequent invited
testimony of experts would help to illuminate the success
of similar databases across the country.
9:32:34 AM
Senator Wilson asked Ms. Wing-Heier to address how the
legislation would help with larger health care problems,
such as the 80th percentile rule, in the state.
th
Ms. Wing-Heier replied that the 80 percentile rule had
been controversial. She stated that the database would
allow the state to compare with other states and Medicare,
which would allow for comparisons to establish cost
differences. He said that identifying surges of particular
illnesses across the state would be possible, which would
benefit the overall health of the state.
9:34:08 AM
Ms. Wing-Heier turned to slide 15, "Standardized format":
The Secretary shall establish, and periodically
update, a standardized reporting format for voluntary
reporting, by group health plans of:
?Medical claims;
?Pharmacy claims;
?Dental claims;
ligibility; and
?Provider files
Ms. Wing-Heier clarified that the information would be
deidentified. She knew that there had been conversations
about data breaches. She assured the committee the
information would be protected.
Co-Chair Bishop asked whether the secretary identified on
the slide was the secretary of Labor.
Ms. Wing-Heier answered in the affirmative.
9:35:17 AM
Ms. Wing-Heier considered slide 16, "CSSB93 Sectional
Analysis":
Section 1 Establishes a new chapter 92 in Title 21
with the following sections: Section 21.92.010 All-
payer claims database (APCD) is established.
(a)Defines the purpose of a statewide APCD:
1)collect and analyze existing health care cost
and quality data;
2)create a central repository that is objective
and reliable;
3)provide transparent access to health care
information while protecting individual privacy
and proprietary data; and
4)enable researchers, policymakers, and the
public to make informed decisions regarding
health care.
(b)APCD must provide:
1) publishable analytics to improve transparency;
2) systematic collection of data; and
3) enhanced transparency. (c)The director may:
1) require an insurer to submit data;
2)establish penalties to ensure compliance;
3)create agreements for voluntary reporting;
4) solicit, receive and administer funding from
public and private sources;
(5) establish, by regulation, a schedule of
reasonable fees to be charged to an authorized
requestor that is a business entity for the use
and distribution of data from the database to the
business entity; and
6) carry out other activities.
Ms. Wing-Heier affirmed that there was no part of the bill
that would require a union trust to submit data.
Ms. Wing-Heier continued to address the Sectional Analysis
on slide 16:
Section 21.92.020 Selection and duties of lead
organization.
(a) By competitive bid, the director shall select an
organization to manage the APCD.
(b) The selected organization shall:
1) apply to be certified as a qualified entity
under 42 C.F.R. 401.703(a) by the Centers of
Medicare and Medicaid;
2) enter into a contract with a data vendor or
multiple data vendors to perform data collection,
processing, aggregation, extracts, and analytics;
3) be responsible for internal governance,
management, and operations of the database;
4) engage stakeholders in the development and
maintenance of the database;
5) provide an annual report to the director
regarding the status of the database and any
recommendations for change;
6) establish a process for making claims and
other data from the database available for use
and distribution upon request to authorized
users;
7) engage consumer protection stakeholders and
the community in the process to ensure claims and
other data from the database are available in a
format accessible to all authorized requesters;
8) prepare a health care data report each
calendar year that aggregates and analyzes the
data submitted to the database; and
9)perform other duties as required by the
director to fulfill the purposes of this chapter
9:37:38 AM
Senator Wielechowski asked whether Ms. Wing-Heier had
stated that participation by a health trust was voluntary.
Ms. Wing-Heier answered affirmatively. She said that there
was no language in the bill that mandated the trust to
provide data.
Ms. Wing-Heier continued to address slide 16:
Section 21.92.030 Confidentiality.
(a) The APCD shall be secure and confidential and
shall not be subject to public records public
inspection. Aggregated information can be shared as
provided in regulations. Individually identifiable
health care information will be confidential; and
(b) Information in the database will not be subject to
subpoena in any civil, criminal, judicial, or
administrative proceeding.
Section 21.92.040 Eligibility for state grants
(a) A health care insurer that is required to submit
health care data to the statewide all-payer claims
database may not receive a state grant unless the
insurer submits the data as required in AS 21.92.010.
(b) A health care payer that is required to submit
health care data to the statewide all-payer claims
database may not receive a state grant unless the
insurer submits the data as required in AS 21.92.010.
Section 21.92.040 Regulations.
Allows for the director of the Division of Insurance
to adopt regulations.
9:39:11 AM
Co-Chair Bishop wanted to have the Department of Law
address the section of the bill related to subpoenas.
Co-Chair Bishop opened invited testimony.
9:40:11 AM
NANCY GIUNTO, WASHINGTON HEALTH ALLIANCE, SEATTLE, WA (via
teleconference), spoke to her experience with the
Washington Health Alliance. She stated that much of the
work of the organization came from a voluntary all peers
claim database started in 2007. She shared that her
organization was considered a trusted and neutral third
party. She reiterated that all parties involved submitted
demographic and pricing information voluntarily. She
stressed that security of patient data was vital, and many
precautions were taken to ensure patient information
safety. She shared that reports were developed
collaboratively in a robust committee structure, and
[participants helped to decide what was reported and how it
was reported. She explained that employers and union trusts
used the information to design benefits and to inform
wellness program initiatives. She added that providers used
the work in their quality improvement efforts and health
care plans used the data for marketplace benchmarking. She
highlighted two recent reports that showcased how the APCD
was used in Washington and how it might be used in Alaska.
She mentioned the Community Check-Up report, which included
data on health care quality across the State of Washington.
The findings had consistently showed that the door patients
walked through was directly related to the quality of care
they received. She related that the quality of care between
medical groups in the state varied. She said that the
second report titled, First Do No Harm. She said that
care that was not based on clinical evidence was wasteful
and caused harm to patients either physically, mentally, or
financially. She asserted that the report revealed that
there were 47 common procedures and treatments that were
consistently overused by trusted national clinical experts.
She said that over a four-year period, 51 percent of the
services measured were of low value, and over $703 million
had been spent on this unnecessary care in the State of
Washington. She stated that there were several initiatives
underway to eliminate wasteful care. She applauded the
State of Alaska for considering APCD and offered full
support for passage of the legislation in Alaska.
9:44:39 AM
Senator von Imhof asked whether there were members of the
Washington Health Alliance from Alaska.
Ms. Giunto answered affirmatively. She said that Primera
was a member as well as several others.
Senator von Imhof asked which union trusts were part of the
Washington Health Alliance.
Ms. Giunto responded that a group led by Fred Brown was a
participant. She could not recall the name of the group.
Senator von Imhof understood that the Alaska State
Employees Association and the Public Employees Local 71
belonged to the Washington Health alliance and were
participating in the database.
Ms. Giunto explained that her organization worked with
local AFL-CIOs, but she did not believe that the two
organizations mentioned by Senator von Imhof were
participants.
9:45:58 AM
ELIZABETH RIPLEY, PRESIDENT, MATSU HEALTH FOUNDATION,
WASILLA (via teleconference), testified in support of the
bill. She shared that Alaska led the nation in health care
costs. She lamented that cost shifting of rising health
care costs by businesses and governments on to their
employees kept wages flat. She offered the example of the
Mat-Su School District where teachers wages had not kept
pace with the cost of living because benefit costs had
increased. She asserted that businesses and governments
could not manage health care costs because they did not
know what they were paying for. She believed that this was
one of the major the reasons why the medical claims data
was needed. She said that federal state transparency laws
only reflected charges; transparency of costs and claims
data. would provide adequate information for customers to
meaningfully budget. She listed various reasons why the
claims data was critical for improving health care in the
state. She spoke of the costs of behavioral health visits
and the difference between the actual costs versus what was
claimed. She said that the claims data could be used to
inform local intervention and to lobby for regulatory and
statutory changes that would reduce the cost of healthcare
for citizens and businesses. She said that the foundation
was committed to the intent of the legislation. She cited a
letter of support for the bill (copy on file).
9:49:41 AM
JOHN FREEDMAN, PRESIDENT, FREEDMAN HEALTH CARE,
MASSACHUSETTS (via teleconference), spoke in support of the
bill. He shared that he served as a physician, working with
his colleagues to help state government on policy and
health care improvements, with a special focus on APCD. The
company had been selected by the Alaska Healthcare
Transformation Project to work on an assessment of the
APCD. He referenced a report entitled "Assessing the
Feasibility of a Sustainable Alaska All-Payer Claims
Database," (copy on file).
Mr. Freedman discussed that health data was necessary to
drive systemic improvement in health care in Alaska. He
shared that during the current pandemic several states had
used APCD to target specific health interventions by
identifying the most at-risk members of their population
for Covid-19; additionally, those states had also studied
trends in tele-health and examined varying costs by
provider and geographic location. He discussed the cost of
running an APCD, including identifying a lead non-profit
organization with expertise in data management. The start-
up phase of an APCD typically could take up to 12 months
and could cost roughly $200,000 to $300,000 to secure stake
holder participation. He estimated that the foundational
year would cost approximately $1 million. He furthered that
once the APCD started to generate reports the annual cost
could increase $2 million, depending on the volume and
complexity of data requests. He said that once the program
was at full operation additional upgrades could cost up to
$1 million in additional funds.
9:54:36 AM
Mr. Freedman thought given the recent federal legislation
the proposed bill had good timing.
9:55:00 AM
Senator von Imhof thought Mr. Freedman had indicated he
worked with over 20 states on the issue.
Mr. Freedman affirmed that he had worked with over 20
states, most of which were continuing, but that Tennessee
had launched a program with a narrow mandate, which had
proved nonvaluable.
Co-Chair Bishop asked whether there had been any states
that had been able to realize savings because of the ACPD.
Mr. Freedman relayed that no states had been able to
publish documented savings in an analytical review. He
asserted that the program offered other value, outside of
cost savings, that benefitted health care customers and
providers. He said that some of the benefits could not be
charted in a quantifiable manner.
9:57:45 AM
Co-Chair Stedman wondered why states were not able to
quantify savings using the data.
Mr. Freedman replied that health costs were volatile from
year to year, and it was difficult to know that an
intervention resulting in savings during any given year was
simply coincidental. He remarked on the disparate benefits
of the APCD.
9:59:32 AM
Co-Chair Stedman commented on Alaska's unique geography and
the different health care cost structures in the state. He
asked whether an APCD would help with comparing costs
within the state and across the nation.
Mr. Freedman stated that data would enable immediate
comparison of procedure costs and costs of care within the
state. He considered that it would be possible to use the
data to examine whether care should be local or otherwise.
He mentioned the forthcoming federal standards, which would
allow for better comparison from state to state.
10:01:25 AM
Senator Wielechowski was curious about the granularity of
the data. He asked whether it would be possible to pinpoint
opioid overuse in a small village.
Mr. Freedman affirmed that it was possible to identify
local opioid hotspots or infectious disease outbreaks down
to the individual, without personal data. He thought
another important use case was for benchmarking and
comparing community practices. He believed that sharing of
data created the opportunity to raise standards across the
state.
10:03:15 AM
Ms. Wing-Heier interjected that she was quite cognizant of
confidentiality considerations for the small villages in
the state and would not aggregate date to a village of less
than 100 people. She said that communicable disease
outbreaks in small communities would not be tied to one
small village.
Senator Wielechowski stressed the importance of the issue.
He was concerned that people that had had abortions, people
with AIDS, and people in small communities could be
targeted for their health care choices and practices.
Mr. Freedman associated himself with Ms. Wing-Heier's
comment. He stated that there were well-established privacy
protections under Alaska state law and HIPPA. He
acknowledged Senator Wielechowski's valid concern and
thought other states had handled the issue well.
10:06:19 AM
Senator von Imhof wanted to point out that there were 20 or
more states that had started using an all-claims database,
to the point where a manual had been drafted. She had been
involved with the issue for five years and shred that the
question of economic benefit had been at the forefront of
discussions. She mentioned the importance of isolating
factors within the data. She asserted that it was very
difficult to print and publish definitive economic impacts.
She thought the database could provide information about
where dollars were spent and to compare regions within the
state and nation in order to focus limit fund in the
highest impact areas.
10:08:02 AM
Senator Wielechowski wondered whether a provision could be
added that gave patients the choice in whether their data
was entered into the database.
Ms. Wing-Heier replied that she was not sure how that would
work.
10:08:45 AM
Senator von Imhof stated she was working on a potential
amendment with a description of a governance committee. The
committee would have no fewer than 10 members, no more than
20, all members would be Alaskans. She said that the
committee would be tasked with developing privacy policies
pertaining to the data.
Co-Chair Bishop asked if there were more questions for Dr.
Freedman.
10:10:45 AM
FRED BROWN, EXECUTIVE DIRECTOR, PACIFIC HEALTH COALITION,
ANCHORAGE (via teleconference), relayed that he had
submitted written testimony (copy on file). He expressed
concern with certain features of the bill. He thought that,
as had happened in Colorado, the database could end up
costing the state much more that the initial federal grant.
He referred to slide 18 of the presentation and stated that
documentation submitted in the record suggests that public
sector union trusts would be expected to participate. For
example, the December 9, 2020, Freedman Healthcare study
recommends that all public employee health plans be
required to participate in reporting to the APCD. He
wondered whether union trust participation would be
mandatory. He worried about penalties for those who did not
chose to contribute. He referred that committee to his
written testimony.
10:16:51 AM
Mr. Brown concluded his testimony.
10:17:09 AM
Co-Chair Bishop asked whether Ms. Wing-Heier could comment
on the testifiers concerns.
Ms. Wing-Heier turned to slide 18, "Nearly 70% of Alaskans
Covered," which showed a table entitled 'Table 1: Types of
Coverage." She stressed that the union trust data would not
be mandated. She furthered that the table did not mandate
who had to contribute to the database, but to show a
representation of the states population.
Mr. Brown reiterated that he had a question about the
intent of the penalty provision in the grant portion of the
bill. He understood that grants could be lost due to lack
of participation.
Ms. Wing-Heier explained that the provision was intended to
apply to health insurance companies and health insurance
payers, and not for unions. She asserted that
municipalities and school districts were unionized and were
not within the data.
10:19:57 AM
Senator von Imhof reiterated that she had been studying the
concept for many years and had written an article on the
subject for the Alaska Business Monthly in 2014. She had
found that there were many individuals and entities in the
state that significantly profited from health care in the
state. She contended that there were many in the Alaska
health care industry that profited significantly by keeping
the flow of dollars health care opaque, lest the
profiteering they experienced be revealed. She thought if
there was hesitancy behind the APCD, it could indicate that
an entity did not feel comfortable having their financial
information exposed.
Senator von Imhof continued her remarks. She mentioned the
amendment she was drafting. She said that if Mr. Brown was
concerned that public dollars would be used for the
database perhaps, he could contribute financially to the
cause.
10:21:51 AM
AT EASE
10:22:03 AM
RECONVENED
Senator Wielechowski wanted to give Mr. Brown an
opportunity to respond to the assertion that health care
trusts could lose profits due to and APCD.
Mr. Brown affirmed that the Pacific Health Coalition was a
non-profit organization.
10:23:11 AM
Senator Wilson asserted that "non-profit" did not mean that
an entity did not make a profit, but rather the entity had
to re-invest profits. He queried the total revenue of the
trust. He understood that one trust entity in the state
averaged $60 million per year.
Mr. Brown replied that Senator Wilson as not speaking about
any of the trusts in the Pacific Health Coalition.
Senator Wilson asked about the average revenue of the
health care trusts under the coalition.
Mr. Brown agreed to follow up with the information. He
believed that the net income to the trust was relatively
minimal.
10:24:26 AM
PATRICK SHIER, PACIFIC HEALTH COALITION, WASILLA (via
teleconference), relayed that he was available to answer
questions.
10:25:01 AM
PETER HAYES, HEALTHCARE PURCHASER ALLIANCE OF MAINE, MAINE
(via teleconference), testified that Maine had had an APCD
for three decades, which had been privately funded in the
beginning. He pivoted to share some success stories to
illustrate the value of the APCD.
Mr. Hayes addressed the importance of having the right
provider, which he thought could make the difference
between life and death for patients. He stated that the
right price was very important. He relayed that before the
APC Maine had some of the most unsafe hospitals in the
rd
country and was now rated 3 in the U.S. for safety. He
shared several anecdotes illustrating how the APCD data had
improved quality and cost of care for patients in Maine.
10:29:45 AM
Mr. Hayes continued his remarks. He said that the tangible
benefits of the APCD were many. He expressed support for
the legislation.
10:32:16 AM
SANDRA HEFFERN, EFFECTIVE HEALTH DESIGN, ANCHORAGE (via
teleconference), explained that she was a consultant with
the Alaska Healthcare Transformation Project. She asserted
that the APCD would assist in the endeavor to provide
reliable and accurate health care data that could be used
to inform how the state was spending on health care, the
cost drivers, and to inform health care policy. She
stressed that the fundamental area that needed to be in
place for market factors to work in health care was
sufficient information on price and quality. She shared
that in 2019, she had reviewed over 300 reports and studies
that had been completed in the past ten years on the Alaska
health care system. The reports provided information on
many of the issues facing Alaskans yet provided limited
generalizable information that could be used to address
systemic solutions. She noted that recent aggregate data
was had to gather and believed that an APCD would be a
beneficial tool.
Ms. Heffern continued her remarks. She commented that a
return on investment was hard to quantify but asserted that
states with an ACPD were able to pinpoint where to expend
energy and health care dollars. She said the project had
issued a request for information from existing lead
organizations to see if there was potential interest in
helping Alaska should the establishment of an APCD be prove
successful. She stated that four responses were used to
craft a formal RFP from the Division of Insurance. The
areas included security and privacy of data. In conclusion,
she recognized that an ACPD would not lower the cost of
healthcare. However, the data would assist in making policy
decisions. She emphasized that submittal of information to
and APCD would be voluntary.
10:36:43 AM
Ms. Heffern reiterated that the information that could be
gleaned from an APCD would be invaluable in the effort to
approve the health care of Alaskans.
10:37:22 AM
BETHANY MARCUM, ALASKA POLICY FORUM, ANCHORAGE (via
teleconference), asserted that many studies had been
conducted on the high cost of health care in Alaska. She
said that good data would be required to understand the
cost drivers. She asserted that Medicaid data had been used
by the federal government to come to false conclusions. She
said that an APCD, as proposed in the bill, could allow for
the collection of information for beneficial use to the
state. She urged the committee to consider the cost of the
project. She hoped the committee would consider how the
project would be funded into the future. She cautioned the
committee to use fiscal restraint but also to consider how
the database would benefit the state.
10:40:12 AM
Ms. Wing-Heier thanked the committee members for their
time. She acknowledged that the subject was complicated but
necessary discussion.
SB 93 was HEARD and HELD in committee for further
consideration.
ADJOURNMENT
10:41:38 AM
The meeting was adjourned at 10:41 a.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 93-(S)FINPresentation-DCCED-DOI-04-29-21.pdf |
SFIN 4/29/2021 9:00:00 AM |
SB 93 |
| SB 93 Supporting - Accessing the Feasibility of a Sustainable APCD.pdf |
SFIN 4/29/2021 9:00:00 AM |
SB 93 |
| SB 93 Summary of Changes (Version A to Version B).pdf |
SFIN 4/29/2021 9:00:00 AM |
SB 93 |
| SB 93 Sponsor Statement (Transmittal Letter) 2.23.2021.pdf |
SFIN 4/29/2021 9:00:00 AM SHSS 3/23/2021 1:30:00 PM |
SB 93 |
| SB 93 Sectional Analysis (Version B).pdf |
SFIN 4/29/2021 9:00:00 AM |
SB 93 |
| SB 93 Opposition ASEA Health Trust.pdf |
SFIN 4/29/2021 9:00:00 AM |
SB 93 |
| SB 93 Letter of Opposition - Public Employees Local 71 Trust Fund 4.27.21.pdf |
SFIN 4/29/2021 9:00:00 AM |
SB 93 |
| SB 93 PHC TESTIMONY SENATE FINANCE 04292021.pdf |
SFIN 4/29/2021 9:00:00 AM |
SB 93 |
| SB 93 04292020_PHC_Letter_2.pdf |
SFIN 4/29/2021 9:00:00 AM |
SB 93 |