5 Things Hawaii: Med-QUEST update, Modernizing public health, Aimee Grace

“We have to make an effort in the United States, we have to make an effort to understand, to go beyond these rather difficult times… What we need in the United States is not division; what we need in the United States is not hatred; what we need in the United States is not violence or lawlessness; but love and wisdom, and compassion toward one another, and a feeling of justice toward those who still suffer within our country, whether they be white or they be black.”

These were the words of Robert Kennedy on April 4, 1968. He offered these the night of Martin Luther King’s death, standing in the back of a truck before a largely Black audience in Indianapolis. I would encourage you to listen to the speech. I must have listened to it 25 times over the last few days.

I’ve been reflecting on Kennedy and King’s works this week as our country descends into turmoil; as the chaos posed by the very few attempts to corrupt the meaningful and important protests by the many.

We have to work harder in the United States than other countries to keep this experiment in self-governance working. We have to work harder than other peoples to reaffirm the common ties that bind us. And, we have to work harder than at other times in our history to address our challenges, and forestall the worst that may be yet to come.

Don’t lose hope that we can solve the deep problems we face. There is no survival value in pessimism.





With help from Emily Boerger

1. “Leadership Series:” Lt. Gov. Green

State of Reform is proud to launch our “Leadership Series,” where attendees will have the opportunity to hear one-on-one conversations with policymakers, health care executives, and the people driving decisions in health care today. This is the same sort of thing that you get from our conferences, but we’re breaking out individual conversations for this COVID time.

We are excited to announce that our first session will feature a conversation with Lt. Governor Josh Green!

On June 11th, from 12:30-1:30 HST, Lt. Gov. Green will share his thoughts about the progress Hawaii has made in managing the COVID-19 crisis both from a clinical perspective as well as an economic one. Registration is free but we’ll need you to sign up in advance to be with us.

2. Med-QUEST RFP update

The Department of Human Services announced on Friday Med-QUEST is rescinding its managed care organization contract awards from January and will instead issue a new RFP this fall. The move, according to DHS, is in response to the “evolving needs of the community” during the COVID-19 crisis.

Prior to this latest announcement, the transition to the new contracts — which pared five plans to two on the neighboring islands — was turbulent. AlohaCare filed a Notice of Protest, legislators introduced a bill pushing against the decision to limit options on neighbor islands, Maui and Hawaii County Councils adopted resolutions calling for the delay of the contracts, and at the end of March Med-QUEST announced they would postpone the original July 1, 2020 contract start date due to COVID. Med-QUEST says it’s too early to determine if the number of health plans will be limited for the neighbor islands in the new RFP.

3. Economic woes on the horizon

The Hawaii Department of Business, Economic Development and Tourism (DBEDT) recently released its second quarter 2020 Statistical and Economic Report, detailing the state’s current economic situation and estimates of the long-term changes brought on by the COVID-19 pandemic. The latest numbers are worrying.

Based off immediate impacts already seen in the state, DBEDT projects Hawaii’s economic growth rate will drop by 12.1% in 2020, and will then increase slowly at 0.7% in 2021, 0.6% in 2022, and 1.1% in 2023. Based off trends seen during the 2009 Great Recession, the report forecasts it will take six years for the number of arriving visitors to reach the 2019 level, and it will take two years for non-tourism businesses to recover to the 2019 level in terms of job count.


4. Video: Aimee Grace, MD, University of Hawai’i System

Aimee Grace, MD, MPH, is the Director of Health Science Policy at the University of Hawai’i System. In her role, Grace directs strategic health initiatives and federal affairs for the University of Hawai’i System and leads the UHealthy Hawai’i initiative. She joins us in this edition of “What They’re Watching” to discuss health workforce challenges in Hawaii.

“How do we engage folks like pharmacists who are very highly trained and don’t often get integrated as well into primary care as we want them to be? We’ve seen incredible outcomes when they’ve been partnering with primary care providers in terms of getting diabetes better under control and high blood pressure better under control. So, we think those are real opportunities to plug into the community in different sorts of ways that are really going to improve the health of our communities and address workforce shortages at the same time.”


5. Modernizing public health

One of the most pressing policy topics ahead is how best to modernize public health for a post-COVID world. Yet, there is really hardly any conversation about the topic. So, as part of our series “The Special Session,” I take a crack at first defining the challenges ahead of reform.

I then outline four areas I think policymakers can consider to promote modernization of our public health system. The list includes centralizing operational responsibility and authority for pandemic response at the state level, requiring Medicaid and public employee purchasing to play a role in pandemic response, using the tools of big data to support disease surveillance, and committing new dollars to public health.