Dunleavy seeks Medicaid overhaul with no advance planning

Gov. Mike Dunleavy is moving to hire a “senior advisor and strategist” for about $295 an hour to tell him how to cut health care for poor people in a hurry. One of the potential contractors has a simple question.

The Medicaid health care network is complicated, expensive and major changes will directly impact the lives of hundreds of thousands of Alaskans and the economics of nearly every health care provider in the state.

Any senior advisor and strategist worthy of the name would want to know that real planning has taken place before overhauling the system. Dunleavy wants to cut $700 million from Medicaid, but there is no plan.

The state is looking for an expert to work 850 hours and create nothing less than “a global roadmap that redesigns the Medicaid and public assistance system at a lower cost.”

The work can be done Outside, the state says, but about eight trips to Juneau and/or Anchorage would be needed.

A “global roadmap” is bureaucratic blather that means cutting hundreds of millions in health care services and welfare for poor people in Alaska, which is a goal of Dunleavy and temporary budget director Donna Arduin.

One of the potential contractors/miracle workers asked the obvious question: “What background has been done to set up this project?”

Sometimes you ask a question and you don’t want to know the answer.

The alarming response from the state health department: Nothing. There has been no background work to set up this project.

See question No. 7 on this document, posted July 19, and the reply.

The full question from the potential creator of the global map was: “What background has been done to set up this project? Things like: Stakeholder engagement, provider and health system focus groups, GIS mapping. Basically any baseline data or work that has been already done that can provide framework for the project’s success.”

There has been no preparation, no stakeholder engagement, no health system focus groups, nothing that provides a framework for success.

The state promise to do the background work in the future seems empty.

“DHSS is currently engaging internally in further options for the Medicaid program to meet budget reductions. DHSS will be setting up meetings with stakeholders including providers for their input into meeting budget reductions and their input into further options for redesigning the Medicaid system. The consultant will have access to interface with both DHSS employees and stakeholders working on these efforts,” the state said.

Translated, the governor and health commissioner Adam Crum have not done any of the background work needed to make this work, even if the miracle worker visits Juneau and/or Anchorage more than eight times. If the goal is to create chaos, that is within reach.


Dermot Cole4 Comments