5 Things Hawaii: Session, Amazon, “What you missed”

Thank you to everyone who joined us last month at our 2018 State of Reform Health Policy Conference!  If you weren’t able to join us, check out the day’s highlights.  It captures the energy and essence of the gathering.  You can see many of the speaker presentations, as well.  You can also watch our keynotes with Jeff Arnold from Sharecare, Former Maryland Governor Martin O’Malley, and Judy Mohr Peterson from Med-QUEST for you to watch.

Now, onto 5 Things We’re Watching for Hawaii health care for February.

1.  Legislation moving in the session

With First Lateral next week, we’re keeping an eye on what bills have progressed through committees. Beth Giesting reports for us on some health policy prospects and the major healthcare legislation themes for the 2018 session. Addressing the opioid crisis and creating protections for ACA requirements are two of the more major focuses.

Homelessness and affordable housing continue to be in focus. In all, the Senate HHS Committee has nine bills related to homelessness that have had hearings, where the Senate HMS Committee has three. Senator Green has introduced a bill that would require all health plans to cover the treatment of homelessness, though that bill appears to have been deferred indefinitely as of yesterday.


2.  EMS asks for funding, reimbursement changes

Emergency Medical Services have asked the Legislature again this year for funding for new ambulances. Multiple appropriation bills to fund the ambulances failed to pass last year, but new bills have been introduced in both chambers. We’ll keep an eye on those bills to see if Kauai, Hawaii Island, or Oahu receive the 24/7 ambulances they’ve requested. The House has passed both HB1676 and HB1790 out of committee. Out of the Senate’s four bills, three have not had a hearing scheduled and only one (SB2658) has passed out of committee.

EMS is also requesting changes in current reimbursement practice, which only allows for reimbursement if patients are transported to the ED or the WCCHC. House Bill 216, which was deferred last year, would ease EMS’ financial losses by creating a three-year community paramedic services pilot program. However, this bill has not yet been scheduled for a hearing.


3.  Podcast: Ray Vara and Michael Stollar

In our last edition, I mentioned we would record a live podcast at our State of Reform Conference, and I’m excited to share it. If you’re subscribed to our podcast, then you’ve already had a chance to listen to it. We hosted Ray Vara, President and CEO of Hawaii Pacific Health, and Michael Stollar, CEO of HMSA, for a discussion on organizational leadership in Hawaii health care in 2018.

Ray and Michael share their thoughts on what it means to be a leader in Hawaii’s health care sector, the current political environment, and some of the innovations and collaborations they’ve overseen. You can take a listen here, and, if you haven’t, be sure to subscribe so you don’t miss our future podcasts!


4.  Amazon shines light on the poor opinion of health care

In September, I outlined a strategy for Amazon to enter the health care space. It starts with leveraging their own employees, which appears to be the focus of their release last week. What has also gained focus is how the Amazon release characterized the health care sector. Warren Buffett called health care a “tapeworm.”  I thought that was a brazen term, but apparently it wasn’t.

A CEO of one of the nation’s largest health systems, Providence Health and Services, agreed.  The former editor of Modern Health care kind of defended the sector saying, to paraphrase, ‘no, it’s a cancer not a tapeworm.” Kaiser Health News posted a letter saying health care is a “catastrophic failure.” Piers Morgan, one I am generally loathe to quote about anything, said health care was “a sick joke & the envy of no one.”

Put it all together:  there is not another sector in the US economy as openly ridiculed and derided as the one upon which we will all one day depend, and from which we will all receive services that few of us can afford on our own. That’s the stuff of a strong political backlash ahead.


5. Video:  Laura Reichhardt on the role of nurses

Laura Reichhardt is the Director of the Hawaii State Center for Nursing, which was created to address nursing workforce issues. The center collects and analyzes data, conducts research on best practice and quality outcomes, and develops strategies to recruit and retain nurses. Their recent report showed that Hawaii has doubled its number of APRNs. She joins us in this edition of “What They’re Watching” to talk about including nursing in payment transformation.

“We’ve also discovered the APRNs really, really in Hawaii, really do work in the most vulnerable populations. So medically under-served areas, in FQHCs, in health provider shortage areas. So with that regard, I think it’s really important to look at the inter-professional practices and how we can integrate all health professions, at their very best, together so that these vulnerable populations are receiving timely care.”