5 Things Hawaii: Opioids, 1115 waiver, Magellan Hawai’i

We have about nine weeks left of this year’s legislative session with First Crossover coming later this week. We’re tracking legislation, but also keeping our eye on the 1115 waiver, and broader issues in Hawaii healthcare.  You’ll see those among the 5 Things We’re Watching in Hawaii health care for March.

1.  DHS 1115 waiver accepting comments

DHS has released an outline of its 1115 Medicaid waiver to begin seeking public comment. The document says “Hawai‘i will request to advance the use of value-based payments to MCOs. MQD will request to provide new performance incentive payments to primary care providers.” New investments in health information technology will also be a “foundational building block” under the waiver.

In large part, the new document builds on the current 1115 Waiver, which expires at the end of this year.  Public comments are accepted until March 19th. Judy Mohr Peterson, Med-QUEST Administrator, spoke about Hawaii’s Medicaid system and the waiver renewal as our afternoon keynote speaker at our 2018 Hawaii State of Reform Event. You can watch her address here, or review her slide deck here.

2.  What opioid addiction looks like, in photos

If you haven’t seen Time’s recent photojournalism showing what the opioid epidemic looks like in America, it’s worth your time. It’s powerful. “If there was a terrorist that showed up… and shot 50 people or 25 or 10 for that matter, this community would be in an uproar. There would be an army here trying to stop it. That’s exactly where we are with opioids.  But who’s showing up to stop it?”

This session, legislators are considering a bill to increase access to naloxone, a billto require prescribers to consult the electronic prescription accountability system, and a bill to fund substance abuse treatment programs as part of Hawaii’s response to the opioid crisis.

Notably, while the US has had a 14% increase in overdose deaths, Hawaii has seen a decrease of 0.5%.


3.  Bills with momentum in the session

First crossover is later this week, so we have a rundown of some of the health policy bills that we’ve been tracking. Notably, despite multiple bills related to addressing homelessness and affordable housing, not much has moved out of committees besides HCR 31, which requests an audit of all programs dealing with homelessness that are administrated by DHS.

Senate Bill 3104 is scheduled for Third Reading and would create new requirements for pharmacy benefits managers and maximum allowable cost. Other health care bills that have moved forward include three bills with funding for EMS ambulance services.

Arguably one of the most watched bills is the Medical Aid in Dying bill, which is schedule for Third Reading in the House. It has received support from the Governor’s Office, the Lieutenant Governor, the Attorney General, and the Department of Health.


4.  Podcast: Homelessness and the Healthcare System

Both in Hawaii and across the country, the problem and challenge of housing insecurity continues to grow, continues to challenge our sense of community, and continues to fall short of the needs of individuals in distress. In this podcast, recorded at our 2018 Hawaii State of Reform Health Policy Conference, we hear from three thought leaders on how to approach this complicated crisis.

We hear from Senator Josh GreenDaniel Cheng, MD from The Queen’s Medical Center, and Pam Witty Oakland, the Director of Honolulu County’s Dept. of Community Services. You can take a listen here.

5. Video: Terah Cochrane, Magellan Hawai’i

Terah Cochrane is the Senior Vice President of Sales at Magellan Health. Magellan Health provides managed care services, with an emphasis on behavioral healthcare. Terah joins us in this edition of “What They’re Watching” to discuss cross pollinating silos.

“We’re focused on innovation. We’re focused on new products. We’re focused on what’s going to propel us for the next twenty years in terms of getting people involved in their health, sustainability, optimization, and what tools do people need to make that happen. Absolutely try to cross-pollinate.”