The Yukon Kuskokwim Delta Regional Hospital, run by the Yukon-Kuskokwim Health Corporation is seen on Oct 12, 2025. (Photo by Corinne Smith/Alaska Beacon)
As Alaska embarks on its implementation of $272 million in funding for the Rural Health Transformation Program, I want to offer a vision for transformation in Alaska.
Alaska’s healthcare system has experienced tumultuous challenges this decade, and it should not be lost on any of us that the very definition of “transformation” is more change. The question I ponder is how will we react to this next iteration of change — will we naively view it as the cure-all that will save our healthcare system, or despair over the magnitude of the task at hand and the potential failures ahead? I hope it’s a reasonable combination of the two in which we remain grounded in the reality of our state’s unique needs while seeking measurable progress over time.
Having over a decade of experience working in different facets of Alaska’s healthcare system, I see transformation not as a big splash or flashy technology. I see it as addressing the basic systems for accessing care in a way that sets a foundation for sustainability and a healthier Alaska. Improved access to care is at the heart of transformation.
What does improved access look like? Look at the Medicaid trends in our state. The top 20% of Medicaid recipients by cost account for 81% of total Medicaid spending in the entire program. The average Medicaid spending per person without diagnosis of a chronic condition was $4,581 in 2024 while the average spending per person diagnosed with one or more chronic conditions was $26,499. This is six times higher and essentially tells us that a relatively small population drives a large majority of healthcare spending.
Improved access can start there. While I have been saying for years the best path to transformation is addressing socioeconomic factors and social determinants of health, mitigating and managing chronic conditions is meaningful progress that clearly can help improve healthcare spending over time.
Whether it’s investments in patient-centered medical homes and addiction medicine in Fairbanks, directed primary care in Petersburg, population health on the Kenai Peninsula, dental health services at nursing homes in Anchorage and beyond or behavioral health respite in Kotzebue, there are real, tangible steps to take to increase access, improve health outcomes for Alaskans and journey to transformation.
It is also important to remember that Alaska is well positioned for this change.
Look at Alaska’s presence in the United States Senate with Senator Sullivan and Senator Murkowski. Not only did Senator Sullivan and Senator Murkowski secure what may amount to over a billion-dollar investment in Alaska, they continue to press the Centers for Medicare and Medicaid Services to prioritize the needs of our state. They also demonstrated leadership with their votes to extend the enhanced premium tax credits that have been relied upon by so many Alaskans and small businesses to purchase health insurance. They both share a genuine interest in helping us achieve rural health transformation.
We have a passionate, dedicated team at the Alaska Department of Health. Commissioner Hedberg and her team have been relentless in their efforts to outperform every state in the rural health transformation sphere. They produced a high caliber application that received the second highest funding award from CMS in the country. While other states deployed large teams and consultants to draft applications, the leadership at DOH relied on a team of 5 public servants working long hours and weekends to produce an application that gives all of us a chance for success.
Finally, we have a deeply passionate constituency. From dedicated Legislators in the Alaska House and Senate asking important questions and exercising critical oversight to ensure accountability and public confidence, to stakeholders and advocates craving change in the healthcare landscape, we are bound together as Alaskans as we work to solve the next complex problem.
I recognize there are so many unanswered questions about this funding, and trust me, I have a lot of questions too. But I also know if we come together in the spirit of collaboration that we are so accustomed to as Alaskans, especially in healthcare, we can make transformation a reality.
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Courtesy of Alaska Beacon
