Video & highlights from “5 Slides: How the Healthcare Community in Hawaii is Responding to COVID-19”

On Wednesday we held our “5 Slides: How the Healthcare Community in Hawaii is Responding to COVID-19” virtual convening. The conversation featured Mark Mugiishi, MD, President & CEO at Hawaii Medical Service Association, Ray Vara, President & CEO at Hawaii Pacific Health, and Mary Boland, DrPH, Dean and Professor of the School of Nursing and Dental Hygiene at the University of Hawaii at Manoa.

During the convening, the three leaders described COVID’s impact on Hawaii and touched on numerous issues including the economy and tourism, testing, preparedness, and health equity.



Hawaii has been one of the hardest hit states economically due to the pandemic. The collapse of the tourism industry has had a significant, immediate impact on the state, with repercussions expected for years to come. Ray Vara kicked off the 5 slides conversation with a slide evaluating three possible tourist screening methods and the impact they could have on positive COVID cases in the state.



The blue curve represents using a questionnaire-type screening for visitors, the orange curve includes the screening questions and adds a temperature check, and the green curve adds an additional requirement that a passenger have a negative COVID test within 72 hours prior to departure.

The projection assumes Hawaii will have 10,000 visitors per day for the rest of the year. Based on Johns Hopkins data, Vara says additional temperature checks should remove about 33% of infectious travelers, while the negative COVID test requirement would remove around 80% of infected travelers.

In all three projections, says Vara, the state has the capacity to manage these cases within the existing resources in the statewide health care system. However, Vara also notes these numbers assume the state executes its screening, testing, contact tracing, and quarantine plans well, and that communities continue with social distancing measures as appropriate.

“To me this is a really good news story,” says Vara. “…If all of these things come into play, we think that we more than have the capacity to safely begin inviting guests and visitors back into the state.”

From a health plan perspective, Mugiishi brought a slide to the conversation highlighting COVID’s impact on health care financing. The chart represents projections of what HMSA modeled early on.



Mugiishi says that even as the economy recovers, revenue will likely remain below baseline for several years.

“As you start to have economic recovery and re-opening, you see [revenue] start to come back up as people start to get reemployed and employers start being able to put people back on their payrolls. But it never gets back to baseline because there’s a permanent shift of lower revenue due to a migration of people to QUEST that will probably be permanent.”

Mugiishi notes that by “permanent” he means over the course of the next 3-5 years. Revenues are also likely to stay below baseline because employers will demand more affordable options, he says.

Beyond the economy, the panelists offered their thoughts on what Med-QUEST should be doing to support the public health response.

Medicaid enrollment is expected to increase across the country as states see rapid increases in unemployment. Vara says the most important task for Med-QUEST is to prepare for this influx.

Boland added that it would also be helpful for Med-QUEST to make it easier for enrollees to access preventative services like immunizations and mammograms. She recommends Med-QUEST work more closely with the Department of Health and utilize schools to break down barriers to access to this type of care.

“I think going back in and taking a good look at how they reimburse providers and how they help people get access to those services right now is even more critical than in regular times,” says Boland.

The full video of the conversation is available above and all 5 slides are available here.