5 Things Hawaii: The post-ACA system, 1115 waiver, Sen. Josh Green

We are looking forward to seeing almost 300 of you this Wednesday at the 2018 Hawaii State of Reform Health Policy Conference! If you haven’t signed up yet, you can register here to be with us. We would be honored to have you.

Because our conference includes topics and speakers that are as timely as any issues in Hawaii healthcare, we feature some of those discussions planned for our conference in this month’s newsletter. As always, mahalo for reading our stuff, and I hope to see you with us on Wednesday!

DJ 5 Things Signature

1.  Update on the Med-QUEST waiver

Judy Mohr Peterson is the director of Med-QUEST, and is among the more innovative forces in Hawaii’s health care system.  She’ll be one of our keynote speakers this Wednesday.

Med-QUEST is developing an 1115 Medicaid waiver that will be submitted in Q2 of 2018, and we’re told, will create significant flexibility for MCOs.  We understand that the waiver will focus on and invest in primary care, care for high-need, high-cost individuals,  payment reform and support community driven initiatives to improve population health.

Here is one challenge, however.  Following on some earlier reporting, CMS announced December 15th that they will no longer provide federal funds (DSHP) to support innovative state projects.  CMS earned a low ROI from investments in states like Texas, where federal funds were more like charity than catalysts for innovation.  Nevertheless, CMS just approved Texas’s latest 1115 waiver, complete with $25 billion in federal dollars and no innovation, just three weeks ago.

2.  CEOs from HMSA, HPH

I’m excited to be recording one of our podcasts in front of a live audience with you at State of Reform. More importantly, I’ll be joined be two of Hawaii’s most important health care CEOs:  Ray Vara, President and CEO of Hawaii Pacific Health, and Michael Stollar, CEO of HMSA.

The political uncertainty in health care emanating out of Washington DC makes leading health care organizations a unique challenge.  We’ll talk with these two about their vision for moving reform forward in Hawaii, about their particular styles of leadership, and what we might expect from their organizations in 2018.

3. Video:  Senator Josh Green

Senator Josh Green is the Chair of the Senate Committee on Human Services, as well an emergency room and family medicine physician. He joined us in this edition of What They’re Watching to discuss the H4 project – a medical service hub aimed at providing healthcare to individuals experiencing homelessness. Sen. Green, along with Dr. Daniel Cheng, The Queen’s Medical Center, and Pam Witty Oakland, Honolulu County, will also join us on the 10th for our “Where Homelessness and the Healthcare System Interface” panel.

“We can save 43 percent of all healthcare costs by having a facility like [H4]. If people need acute care, or urgent care for basic stuff, like wound care, they see us at the second floor. If they’re coming out of the hospital, and instead of going to the street, they go to third floor and save thousands and thousands of dollars everyday. And when they’re ready, they can live on the fourth floor or go into permanent housing anywhere across the state. This project will deliver services to several thousand people and save the state over $35 million a year.”


4.  Legislators on the post-ACA health system in Hawaii

One of our more interesting panels of the day on Wednesday hosts Rep. Della Au Belatti, Sen. Roz Baker, Commissioner Gordon Ito, and AlohaCare CEO Laura Esslinger. That’s an impressive lineup to begin with. Their topic area is just as unique.

What should the post-ACA health system look like in Hawaii?  Should it move beyond the ACA to perhaps expand Medicaid eligibility further?  Should it refocus on strengthening and maybe expanding on the Pre-Paid Health Care Act?

These are the kinds of topics the session will take on. This panel is teed up at 2:00 on Wednesday, and will likely be a well attended discussion.

5.  The increasing need for cross-silo care strategies

As awareness continues to develop about how better health outcomes for the individual requires better care coordination from the system, the work among organizations managing patients across multiple systems of care is complex, unique, and often inspiring.

We have a panel bringing some of this work forward featuring some of Hawaii’s most thoughtful executive leaders. At 9:45 on Wednesday, we’ll host from David Heywood, President of United Healthcare; Wes Lo, CEO of Hale Makua; and Hilton Raethel, CEO of the Healthcare Association of Hawaii.  They’ll talk through what reaching across silos looked like in 2017 and what we might expect to see in 2018.