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Office of the Commissioner

Office of Rate Review 


Mission: We provide quality Medicaid rate setting services to ensure access to healthcare, support the department’s programs, and ensure responsive health facility and services development.

Vision: All Alaskans will have the ability to access high quality medical services.

Core Values and Guiding Principles:
  • Integrity – “We believe in and conduct ourselves with integrity and believe to do so is vital to the work we perform; we are open and honest with each other, our partners and stakeholders, and treat each with dignity and respect.”
  • Professionalism – “We believe in executing our work with the utmost professionalism and our work product exemplifies this.”
  • Transparency – “We believe in being transparent with each other and with our partners and stakeholders; this allows us to work efficiently and be highly productive.”
  • Collaboration – “We believe collaboration in our work and relationships is vital to our success; therefore sharing of information and working closely with each other, our partners and stakeholders is highly prioritized.”
  • Innovation – “We believe in innovation and strive to learn and evolve in the work that we do; we are open to all opportunities to expand our knowledge base.”

Programs

  • Certificate of Need
    The Certificate of Need (CON) program is a review process used to promote responsive health facility and service development, rational health planning, health care quality, access to health care, and health care cost containment.
  • Supplemental Emergency Medical Transport
    The Supplemental Emergency Medical Transport (SEMT) program is a voluntary program that will allow eligible publicly owned and operated Medicaid providers to voluntarily submit annual reports to be reimbursed Medicaid supplemental payments. 

Initiatives

  • Diagnosis Related Groups
    The Diagnosis Related Groups (DRG) project is an effort to move from a cost-based per diem prospective payment system for inpatient hospital services to a DRG system based on the intensity of services provided.
  • Skilled Nursing Facility
    The Skilled Nursing Facility (SNF) Case Mix Based Payment Methodology project is an effort to move from a cost-based per diem payment system to a case mix reimbursement payment system based on patient case mix indices (CMI) or acuity.