5 Things HI: Michael Robinson, Pacific VA, HMSA performance

Health policy isn’t disconnected from political reality. So, it’s possible the most important health policy activity today comes from Jim Comey’s testimoney before the US Senate. If you weren’t up at 4:00 am for his remarks, you can read them here. They read like a Hollywood screenplay.

With that, here are 5 (other) Things We’re Watching that impact health care in Hawaii for June, 2017.

1.  Point in Time homelessness report

The recently released Homeless Point-in-Time (PIT) report indicates that there was a decrease of 9% in Hawaii’s overall homeless rate from last year.  This is mostly attributed geographically to Hawaii and Maui, with Oahu showing a slight increase in homelessness.  About half of the homeless families have children under the age of 12.

That is a significant shift, though one without a clear explanation for why. Medicaid plans are still grappling with how to manage the care of these families and individuals.  Policy makers are still elevating the issue to the top tier of policy dialog. Perhaps the importance of the findings is in the momentum it offers rather than any road map to success.

2. Video:  Michael Robinson, HPH

Michael Robinson is the Vice President of Government Relations and Community Affairs at Hawaii Pacific Health and one of the savviest operators we know in Hawaii policy circles.  He has his finger on the pulse of what’s happening in Hawaii health care and health policy – and he is looking beyond the normal scope of health care.

In this latest edition of “What They’re Watching,” Michael explains why Hawaii Pacific Health remains focused on community engagement. “No matter how big you are or no matter what excellence you’re providing to your patients, we have to be very thoughtful and very proactive in reaching out to people outside of what we traditionally think of as health care.”

3.  John Oliver on dialysis: “a drunk donkey”

It’s not often that health policy mixes easily with pop culture. Last month, I highlighted Jimmy Kimmel’s monologue about his newborn son as an example. Two weeks ago, John Oliver provided another window into how the rest of the world views the health care industry when he took on dialysis at DaVita on his show on HBO.

Oliver points out that while 2% of the federal budget goes to the Dept of Education, a full 1% of the budget goes to kidney dialysis. Interestingly, our story on lawsuits facing DaVita from March has shot back up to be one of our most read stories across our entire site. Between DaVita and Fresenius, they together control about 70% of the dialysis market in the US.  Both have multiple locations in Hawaii.

4.  Importing problems to Pacific VA?

Jennifer Gutowski is the new director of the VA Pacific Island Health Care System. She comes with 18 years experience in the VA, most recently as the Acting Director of the Arizona VA system.  The Arizona VA system was one of the primary locations of recent whistle blower activity highlighting problems in the VA system. Ms. Gutowski was specifically named in a VA report as covering up and manipulating wait times. In an interview with the ABC affiliate, Ms. Gutowski said “we own that” in response to the report’s findings.

In a blistering column, Maria Blom Hill lays out several concerns about Ms. Gutowski’s appointment. Bill Flynn of Kona’s VFW Post said bluntly “We don’t want her here at all.”

That said, credit Ms. Gutowski with a willingness to face her critics and engage directly with stakeholders since beginning her role May 15.  She recently spoke with Hawaii Public Radio, and attended a community meeting with veterans on Kauai. Let’s hope a challenging VA system can learn from some of the missteps of the past.

5.  HMSA’s financial performance is good for HI

HMSA reported a significant financial improvement for the first quarter of 2017 compared to Q1 2016.  This comes after having three years of operational losses.

HMSA is in a unique situation in Hawaii that gives reason for folks to root for its financial performance.  Its membership of 735,000 is about 52% of Hawaii’s population. It’s leading the nation on paying for value over volume.  And, generally speaking, people pay less out of pocket for health care in Hawaii than other states, so the system is working on that score. The size of the plan’s market share allows it to drive innovation and mitigate against costs that is the envy of almost every other state.