In response to Jim Grazko’s commentary, “Repealing 80th percentile rule is vital to Alaska,” his argument is that the only way to reduce health care costs in Alaska is for health care insurers like Premera to bring them into the network and control how much they will pay. He emphasizes the difference between price and cost, with the insurer focusing on the price they pay and health care providers concerned with the cost of providing care.
However, Sandra Heffern argues that the repeal of the 80th percentile will not be the “easy button” to reducing Alaska’s high health care costs. She points out that health care pricing and costs are complicated, and that providers strive to provide high-quality care for Alaska patients.
Grazko compared Premera Alaska’s health care costs to those in Washington, but did not provide information on what other commercial insurers are currently paying. He also mentioned Medicaid and Medicare, but failed to offer specific comparisons to commercial insurance products.
Heffern’s point is that it would be difficult for Premera to compare the amounts paid for health care across multiple payers, as Alaska does not have the structure to collect or analyze this data. She suggests that an all-payer claims database, like those in other states, would help better understand who is paying for what.
However, Heffern also highlights that an all-payer claims database may not necessarily lead to lower costs as it might not address some of the underlying issues such as provider pricing power or administrative burden on providers.
It is important for stakeholders in Alaska’s healthcare system