5 Things Hawaii: Dave Underriner, Haley Hsieh, Health Disparities

Our January 2019 event seems like it is so far away, and it is!  But we’re beginning our planning for the annual event now.  We host our Convening Panel meeting in September.  But, if you’re interested in helping to shape the conversation, drop us a note.  We’re always looking for smart voices for our Convening Panel, good ideas for speakers, and engaged stakeholders that might want to explore a sponsorship.

With that, here are 5 Things We’re Watching in Hawaii’s health care system for April 2018.

DJ 5 Things Signature

1.  Dave Underriner to lead Kaiser Permanente

On Monday, Kaiser announced their new choice to lead the 225,000 member system in Hawaii:  Dave Underriner, CEO of Providence Health and Services Oregon.  I’ve had the pleasure of getting to know Underriner in Oregon, where he is a well respected hospital system administrator.  He has managed sometimes challenging politics in the Medicaid space in Oregon, and has had to make some tough choices related to “right sizing” staffing in the region.

Through it all, he has appeared to be a capable, effective administrator, something KP probably needs as it continues to integrate its three new hospitals on Maui.

You can watch Underriner’s comments during the Executive Keynote Panel at our 2015 Oregon State of Reform Health Policy Conference where he talked about his approach to organizational leadership during a transitional period in health care.

2. Video: Haley Hsieh, Laulima Data Alliance

Haley Hsieh is the Executive Director at the Laulima Data Alliance, a subsidiary of HAH that provides comprehensive data analytics to improve access and quality of health care in Hawaii. Hsieh joins us in this edition of “What They’re Watching” to talk about using patient data across multiple facilities.

“The whole mission and goal is to eventually have the whole continuum of care and all of the data underneath it so that you can really, through data, support the whole continuum of care… Are there any trends? Are there any patterns? Are there ways for the post-acute to work better with the acute? And really the data will help make those decisions.”

3.  Hawaii’s health disparities by county, race

The Robert Wood Johnson Foundation has published the 2018 County Health Rankings Report for Hawaii. The report ranks Kauai County first in health outcomes and Honolulu County first in health factors. Hawaii County was ranked fourth in both categories.

The data reveals slight health disparities by county. For example the adult obesity rate is 20% in Kauai and 23% on the Big Island and Maui. High school graduation rates vary from 77-86% and the uninsured rate varies from 4-6% by county.

However, health disparities are more significant by race. Only 9% of whites report poor or fair health compared to 22% of Hispanics. On average, blacks report 6.2 poor physical health days per month compared to 2.5 days for Asians and Pacific Islanders. But the report does not have a separate category for Native Hawaiians, who had poor health factors and outcomes in this CDC study last year. You can explore the data here.

4.  Medicare enrollment up, Medicaid decreasing

Hawaii’s new enrollment numbers show that since January ’17, Medicare Advantage enrollment has increased 5.5 percent as of last month while Medicaid enrollment has decreased 1.4 percent as of Jan ’18. Total MA enrollment by state can be found here.

HMSA, Kaiser and UnitedHealthcare cover about 80 percent of MA enrollees. But United added over 3,200 new enrollees while HMSA stayed relatively stable. Kaiser added just over 2,000 new enrollees to its MA plans.

United also saw the largest change in its Medicaid enrollment with 3.2 percent growth. All other carriers besides HMSA, who has the largest Medicaid share, saw decreases in enrollment from Jan ’17 to Jan ’18. So while Hawaii lost over 5,000 Medicaid enrollees, United managed to add over 1,000 new beneficiaries.

5.  Hawaii ranked poorly for doctors

Hawaii was ranked 48th on the list of best states to practice medicine, which also included DC. The study looked at opportunity and competition, where Hawaii ranked 50th, and medical environment, where Hawaii was 30th.

After adjusting for the the state’s relatively high cost of living, Hawaii was ranked 50th and 51st for physicians’ average annual wage and average monthly starting salary. The only two categories where Hawaii broke the top ten were the insured population rate (2nd) and the punitiveness of the state medical board (5th).