623 Medical Providers and 25+ Professional and Practice Signatories Urge Alaska Governor Mike Dunleavy to Protect and Preserve the 80th Percentile Rule

A March 2023 letter, (find letter here) addressed to Alaska Governor Mike Dunleavy, signed by 623 medical providers and backed by 25+ professional and practice signatories, highlights the crucial need to protect and preserve the 80th Percentile Rule in Alaska. The signatories, all deeply invested in the well-being of Alaska, emphasize the rule's significance in safeguarding access to care for Alaskans and express concerns over attempts to repeal it.

The 80th percentile rule has long been a vital component of Alaska's healthcare system, ensuring that residents have access to quality care within the state. However, recent efforts to dismantle this crucial safeguard have been initiated by Premera, an insurer based outside Alaska. The signatories firmly believe that Premera's motivations do not align with the best interests of the state.

“The 80th percentile rule continues to protect Alaskans’ access to care here in our own State but renewed efforts to repeal it are being driven by Premera, an insurer based in the lower 48. They are not acting in our State’s best interest. The argument that the rule’s repeal will lower costs, while somehow not reducing quality or access, is based on decades old data. A lot has changed for the better in 20 years. Unlike in 2004, we have more providers, most of whom are in network, under contract with insurers reducing costs, minimizing balance billing, and caring for more Alaskans. Abrupt repeal of the 80th percentile rule threatens this stability,” the signatories wrote.

Proponents of the rule's repeal argue that doing so would lower costs without compromising quality or access, relying on outdated data from two decades ago. However, the signatories emphasize the significant positive changes that have occurred in the healthcare landscape since 2004. Today, Alaska boasts a greater number of providers, with a majority contracted with insurers and actively working to reduce costs, minimize balance billing, and care for more Alaskans. An abrupt repeal of the 80th percentile rule poses a severe threat to this stability.

The signatories also draw attention to the importance of considering past behavior as a predictor of future outcomes.

“Repealing this rule will return us to the days before 2004, when doctors were hard to recruit and patients faced big bills. Our rural areas, seniors, and Medicaid recipients will feel the pinch the hardest as the subsidization of government payers by insurance is reduced. Alaska’s Medicaid budget will either increase significantly, care will be reduced, or both,” the signatories wrote.

To make informed decisions regarding the rule, the signatories stress the value of the All Payer Claims Database (APCD), which would provide crucial and timely information regarding medical costs in Alaska. And highlight the fact that physician groups reported a decline of approximately 30% in revenue over the past decade, while the largest insurer in the state had to refund excess profits in 2018.

 “Repealing this rule will return us to the days before 2004, when doctors were hard to recruit and patients faced big bills. Our rural areas, seniors, and Medicaid recipients will feel the pinch the hardest as the subsidization of government payers by insurance is reduced. Alaska’s Medicaid budget will either increase significantly, care will be reduced, or both,” the signatories wrote.

In their letter, the 623 medical providers and 25+ professional and practice signatories respectfully request that any repeal efforts be put on hold until the APCD becomes available and has been thoroughly reviewed by a panel of stakeholders, and recommendations be made to the benefit of all Alaskans.

To review the full letter by 623 Medical Providers and 25+ Professional and Practice Signatories, click here.