5 Things Hawaii: QUEST Integration RFP, Scott Miscovich, Workforce study

It seems like a long ways away, and it is… But, we are starting to gear up for our 2020 Hawaii State of Reform Health Policy Conference coming up on January 14, 2020. Our Convening Panel will be gathering to talk through the most relevant and most important topics to tee up on the January agenda.

So, if you have ideas for speakers or for sessions, now is a good time to share those!  We’ll put them in the mix during our Convening Panel process. Just hit reply to this note if you have suggestions and we’ll include them.


DJ 5 Things Signature

With help from Emily Boerger



1. DHS releases Medicaid Managed Care RFP

The Hawaii Department of Human Services (DHS) released its QUEST Integration Medicaid Managed Care RFP last week. According to the Request for Proposals, DHS plans to contract with four health plans to provide service for Medicaid and CHIP members in Hawaii. All four will serve members in Oahu, and two will operate statewide.

The RFP places an emphasis on advancing primary care, team-based care, prevention and health promotion, behavioral health, and addressing social determinants of health. Proposals are due November 8, 2019 and awards will be made January 6, 2020. Links to the full 638-page RFP and its appendices are available here.


2. Q&A: Dr. Scott Miscovich on new H4 facility

The new Kaneohe Joint Outreach Center recently opened to serve individuals experiencing homelessness on the Windward side of Oahu. The medical clinic, which is operated by Hawaii Homeless Healthcare Hui (H4), will provide walk-in medical services, social services, referrals for mental health and drug abuse treatments, as well as food supplies and hygiene items.

Reporter Emily Boerger recently caught up with Dr. Scott Miscovich, one of the co-founders of H4, to discuss the Kaneohe Joint Outreach Center and H4’s overarching goals. “This is taking the approach that Lt. Gov Green and I have supported with the founding of our non-profit. We feel that someone needs to address the most difficult and challenging homeless sub-groups in the state of Hawaii… This is the group that needs really advanced, very well-trained medical professionals and other support social professionals to really start making a difference.”

3. HAH health care workforce study

Last week, the Healthcare Association of Hawaii (HAH) released a report detailing health care workforce shortages in the state. According to the report, there are more than 2,200 health care jobs open across the state, and an average 10% vacancy rate across 76 patient-facing, non-physician professions.

HAH’s survey also finds that most jobs take 6-12 months to fill, and that of the 76 professions evaluated, 19 do not have a Hawaii-based education or training program. Interestingly, the positions in greatest demand in Hawaii are medical assistants, nurse aides, registered nurses, patient services representatives, and phlebotomists.

4. Video: Enrique Terrazas, Quest Diagnostics

Enrique Terrazas is the Senior Medical Director, Medical Quality at Quest Diagnostics. He joins us in this edition of “What They’re Watching” to discuss lab stewardship. This is the extension of the “right care at the right time and the right place” approach to the lab setting.

“One of the things that our health system and hospital clients are focusing their energy on is lab stewardship… You know, the effort is to drive better patient care, better patient outcomes, reduce unnecessary testing, and arrive at the correct diagnosis. So, you want to do the correct testing in order to do that.”


5. “Don Quixote” goes to Washington DC

National Democratic figures are laying the ground work for health reform policy in a new administration, hoping that the 2020 election will swing their way. One of the quieter but perhaps more influential players in this discussion is former Oregon Governor John Kitzhaber. He spoke at our conference back in 2017. Kitzhaber has been steadily convening key federal policy advocates, both in public and privately, relying on some of the figures that helped land the $1.9bn Medicaid waiver funds in 2012 as part of his CCO transformation there.

I spent a few days with Gov. Kitzhaber on a recent trip to DC as he was trying to focus the opinion of DC insiders away from a solution, and towards a better understanding of the problem. “Medicare for All is really a financing mechanism. And, if we don’t reform the underlying delivery system, the way we finance it won’t get at the root problems of quality in health care.”