Q&A: Patti Bazin, HMSA, on QUEST reprocurement

Over the summer, the Department of Human Services (DHS) released a new request for information seeking information to prepare for the upcoming re-procurement of QUEST Integration (QI) health plans.

The RFI came after DHS announced it was rescinding the Medicaid managed care contract awards previously announced in January due to the “evolving needs of the community” during the COVID-19 crisis.

The transition to the new contracts would have pared five plans down to two on the neighboring islands. HMSA and United Healthcare were originally awarded the statewide contracts, with AlohaCare and Ohana Health Plan receiving contracts to cover Oahu only.

With a new RFP expected to be released in early December, we spoke with Patti Bazin, Vice President of Medicare and Medicaid programs at HMSA, for a conversation on HMSA’s response to the RFI and its vision for the future procurement process.

 

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Emily Boerger: One key question included in the RFI asks about the optimal number of plans for Hawaii and if the number of health plans should vary on a regional vs. statewide basis. What’s HMSA’s stance here?

Patti Bazin: “When we discussed our response to the RFI, we looked at the Med-QUEST Division goals of implementing the HOPE initiative, reducing administrative burden, and to caring for QUEST members. And HMSA is supportive of these goals. 

We also understand where things are today. From our perspective, we understand that with all the changes that are going on related to COVID, making a major change in the number of QUEST Integration (QI) health plans would be difficult for the community. So that’s why our response for the current procurement is to continue with the current structure of health plans that we have right now and not make any major changes. 

Looking toward the future, Med-QUEST has this amazing vision that they’re trying to accomplish, and we want to be part of that. We want to care for our members and continue to be a part of that process. Our recommendation in the future would be to reduce the number of health plans to three in a post-COVID environment.  But that is not today.”

EB: So, in the future, when you’re describing shrinking the number of plans to three, would that be statewide? Or would there be variation based on region?

PB: “We responded that in the future, in a post-COVID world, our recommendation would be going to three health plans statewide.”

EB: Ok. This is probably a difficult question to answer, but what would you consider a post-COVID world? How will we know when we have moved beyond this challenging and unique time?

PB: “We haven’t defined that specifically. Some indicators may be when vaccinations are available and people have received them. When we don’t have to social distance or wear masks and we’re able to be together. Where health care isn’t so complicated for people to receive and where our members feel more comfortable going to the doctor.

But for this procurement that’s going to be issued in the next few weeks, our recommendation is not to go down to three health plans. That is not our recommendation at this point.”

EB: When looking toward that post-COVID time in the future, can you tell me about what HMSA views as the benefits of moving to a smaller number of health plans?

PB: “Some of the goals that Med-QUEST is trying to achieve is a reduction in administrative burden for providers. Working with five health plans is complicated for providers in the health delivery system. A smaller number of QI health plans would help with the collaboration surrounding the HOPE initiative and reduction of provider administrative burden.”

EB: As I was looking through the RFI responses today I noticed a lot of different organizations mentioning the collaborative work that has been underway amongst the plans during the pandemic. What has that been like?

PB: “Oh, I think that there has been a lot of collaborative work amongst the five health plans that are currently in the program right now. 

We’re still competitors but we are collaborative. When it comes to rolling out different programs or projects, we definitely have been more collaborative today than we were earlier. COVID has been a very difficult challenge for the health care community. 

I think that one of the first projects we really worked on together was collaboration around issuing personal protective equipment (PPE) to caregivers for members receiving home and community-based services (HCBS) that become COVID +. Med-QUEST was able to receive PPE and it was then divided up amongst the QI health plans. Med-QUEST distributed PPE to HCBS caregivers of COVID + members on the island of Oahu.  The QI health plans sent PPE to the other islands across the state for those caregivers. HMSA is responsible for PPE distribution to HCBS caregivers of COVID + members for Maui island. So, if any HCBS caregiver of a COVID + member on Maui, no matter what health plan they are in, needed PPE, we were able to deliver it to them.  That process is still going on today.

So, that was one of the collaborative approaches that we had pretty early on and that was not something I think we would have done pre-COVID.”

EB: Do you think this kind of collaboration will continue post COVID?

PB: “Yes, I do think so and I know that’s also one of the goals of Med-QUEST.”

This interview has been edited for clarity and length.