Hawaii

Hawaii's Healthcare Innovation Plan, includes several catalysts for change to achieve the "Triple Aim." The plan focuses on primary care redesign and aims to have 80 percent of the population enrolled in medical homes by 2017. Additionally, the plan aims to implement Health Homes for Medicaid recipients with an existing diagnosis of Severe and Persistent Mental Illness or Serious Mental Illness will qualify for the Health Home. Additionally, Medicaid recipients with at least two of the following conditions will also be eligible: Diabetes, Heart Disease, Obesity, Chronic Obstructive Pulmonary Disease, and Substance Abuse. 

The Healthcare Innovation Plan will also establish Community Care Networks (CCN) to provide extra support to patients and practices with needs not readily addressed by PCMHs. CCNs will be modeled after the Health Home, with similar population criteria, provider standards, aligned quality metrics, technology tools, and services, but they will target Employer-Union Trust Fund and commercial insurance patients.

The implementation of this Healthcare Innovation Plan, however, will not be possible without legislative action, significant stakeholder engagement, and the use of existing policy levers. The state’s efforts will build on the existing assets and opportunities for healthcare transformation to ensure statewide, multi-payer implementation of reforms that are effective and sustainable.

CHIPRA: 
No
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
No
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
No
Private Payer Program: 
Yes
State Facts: 
Population:
1,369,900
Uninsured Population:
5%
Total Medicaid Spending FY 2013: 
$1.6 Billion 
Overweight/Obese Adults:
55.4%
Poor Mental Health among Adults: 
27.5%
Medicaid Expansion: 
Yes 
CPC+: 
CPC+

Hawaii Managed Care Contracting

Hawaii requires Medicaid Managed Care Organizations to report on and increase the percentage of medical expenditures devoted to primary care.

Father of medical home: Dr. Sia remembered as ‘quintessential advocate’

Received PCC's Barbara Starfield Primary Care Leadership Award in 2015

Calvin C.J. Sia, M.D., FAAP, father of the medical home concept of care and Emergency Medical Services for Children Program, died Aug. 19 in Honolulu at age 93.

News Author: 
Trisha Korioth

HB 1444 Primary Care Payment Reform Collaborative

The purpose of this Act is to establish a task force known as the primary care payment reform collaborative to:

     (1)  Examine current levels of primary care spending in the State;

     (2)  Explore primary care spending mandates in other states;

     (3)  Examine alternative methods and models of enhancing primary care spending;

     (4)  Explore data collection issues related to understanding the State's primary care spending, including the capture of non-claims based primary care spending; and

How Primary Care Docs Are Learning To Treat Mental Illness

The patient, pleading for pills, set off alarm bells in the doctor’s head.

When abused, the anti-seizure drug the patient was seeking can produce a euphoric high. Was the patient battling an addiction?

On a computer, the doctor searched a database for the patient’s electronic record, including any recently prescribed narcotics.

News Author: 
Brittany Lyte

Hawaii Comprehensive Primary Care Plus

Comprehensive Primary Care Plus (CPC+) is a new payment model introduced by CMS and is available to all Hawaiian Medicare beneficiaries enrolled in Part A & Part B.

Kapi'olani Medical Center for Women and Children Asthma Task Force

The Kapi'olani Medical Center for Women and Children Asthma Task Force quality improvement project was created to study the relationship between compliance with all three of the Children's Asthma Care (CAC) core measures and readmission rates. The hospital formed a multidisciplinary asthma task force that included hospital-based and community physicians, nursing leadership, respiratory therapists, the hospital chief operating officer, and a QI officer.

PCMH, Asthma Measures Cut Pediatric Readmissions

Compliance with all of the Children's Asthma Care (CAC) core measures — a trio of interventions designed to improve the care of pediatric patients hospitalized because of asthma — was associated with reduced readmission rates, according to a study published online June 16 in Pediatrics.

News Author: 
Diedtra Henderson

CMS State Innovation Model Design Award - Hawaii

Hawaii's Healthcare Innovation Plan identifies six essential catalysts to successfully implement the "Triple Aim":

QUEST Primary Care Patient-Centered Medical Home & Pay for Quality Program

In 2010, the Hawaii Medical Service Association (HMSA) adopted the patient-centered medical home (PCMH) model for primary care providers as its value-based health care initiative. Hawaii QUEST is a Medicaid managed care program run by the Blue Cross Blue Shield health plan HMSA. The HMSA QUEST value-driven health care initiative consists of a PCMH program, a pay-for-quality program, and a Hospital Value-Driven Health Care Program.

Improving the Health and Care of Low-Income Diabetics at Reduced Costs

In June 2012, FirstVitals Health and Wellness Inc., in partnership with AlohaCare, was awarded a three-year $4M CMS Innovation Grant to to implement and test a care coordination and health information technology plan that will better regulate glucose levels for Medicaid-eligible patients with Type 1 and Type 2 diabetes who have the complication of peripheral neuropathy. FirstVitals will create a secured database that will receive data feeds from wireless glucose meters and tablets.

Pagine

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