5 Things Hawaii: Waiver approval, Dan Juberg, Insulin cost bill

Big mahalo for reading our newsletter, and for supporting our work at State of Reform! We are starting to begin our thinking and planning for our 2019 Hawaii State of Reform Health Policy Conference, with our Convening Panel meeting coming up next month.

We’re always interested in our readers’ ideas and thoughts about topics and speakers. So, if you have a few, send them in and we’ll include them in the Convening Panel process!


DJ 5 Things Signature


With help from Emily Boerger


1. CMS approves 1115 waiver

On the last day of the one-month temporary extension on Hawaii’s 1115 waiver demonstration, CMS sent a letter notifying Medicaid Director Judy Mohr Peterson of their approval to extend the “QUEST Integration” project through Jul 31, 2024.

The extension authorizes Hawaii to continue its managed care delivery system and provide additional benefits like HCBS. The letter also authorizes the state to expand access to community integration services through the Community Transition Services pilot program. CMS did not approve the state’s application for increased flexibility for a new Medical Respite Services pilot program, but says the request is still under review.


2. Proposed bill to cap insulin costs

Representative John Mizuno has announced his intent to file a bill next session to cap co-pays for insulin. The proposed bill would cap the price at $100 for a 30-day supply, regardless of the amount or type of insulin needed.

“It is my understanding that insulin prices have increased approximately 555 percent in the last decade and a half and therefore has caused co-pays to sky-rocket to unaffordable rates for our people,” said Mizuno. “As painful as it sounds, many of our residents’ underuse insulin because of its significant cost.” We’ve covered the impacts of similar legislation Colorado adopted.

3. Tulsi, Kamala and Russia

Tulsi Gabbard turned some heads in the recent Democratic presidential debate for hitting Kamala Harris on her record as a prosecutor and as Attorney General in California. It was a powerful hit that Harris appeared surprisingly unready to address. Apparently Russia took note. The state media site “Russia Today” allegedly created and launched the hashtag #kamaladestroyed. Apparently fake Twitter accounts, like this one, began pushing out content to try to drive the national conversation because of the way Twitter activity tends to influence national political news.

This may have dinged Kamala, but it’s not clear it helped Tulsi. She has until August 28th to earn 130,000 unique donors (which she hit last week) and hit 2% in four national polls in order to make the next debate stage on Sept. 12 in Houston. According to a Harvard/Harris poll after the debate, Tulsi remains at 1%. RCL has her at an average of 1.3%.

4. Video: Dan Juberg, Lumeris

Dan Juberg is the Vice President – West at Lumeris. He joins us in this edition of “What They’re Watching” to discuss health systems transitioning to value based care. Lumeris was founded and has been built on the idea of creating infrastructure to support providers moving into the value based care space.

“When you’ve changed the amount that you’re going to be paid, no matter how much service you are [providing], it breeds innovation and having to treat them (patients) in different ways cheaper. That’s really kind of the tidal wave that we’re surfing on right now…”


5. East Hawaii IPA Symposium is next week

We’ll miss this year’s East Hawaii IPA Symposium on the Big Island. It’s one of the really solid conferences on the calendar that gathers a “who’s who” of health care leaders and organizations. I commend it to you if you are looking for a good professional gathering next weekend.

This year’s agenda has a focus on leveraging community supports as part of the care team within an integrated care model. It also will “reflect upon the toll that system transformation has on providers and how to manage the pressures.”