Managed Healthcare Executive - January 2009 - (Page 29)

State Report Hawaii COMMONWEALTH FUND STATE PERFORMANCE RANKING (2007): 1 SEVEN MONTHS after launching Keiki Care, Hawaii ended the universal healthcare program for children. The state stopped funding the program effective Nov. 1, 2008. Its private partner, Hawaii Medical Service Assn. (HMSA), paid to cover the 2,000 children enrolled in the program through the end of 2008. Gov. Linda Lingle (R), who signed the program into law in 2007, said a state budget shortfall prompted the funding cut. Hawaii faces a projected $900 million general fund de cit by 2011. The state contributed about $50,000 monthly, or $25.50 per child, to the program, which was available at no cost for participants, except for a $7 copayment for physician o ce visits. All uninsured children up to age 18 were eligible for the program. According to the Department of Human Services, about 85% of children in Keiki Care previously were covered by HMSA’s Children’s Plan but stopped paying for it so they could take advantage of the Keiki program. The Commonwealth Fund ranks Hawaii the best overall state, especially in terms of access to care. Physicians who serve high numbers of Medicare patients in Hawaii and two other states say they are defaulting on rent, laying o sta and asking drug suppliers to send drugs without payment because of a backlog of Medicare reimbursements. Problems stem from reconciling national provider identi ers assigned by the Centers for Medicare and Medicaid Services (CMS) last May. HAWAIIANS USE ‘VIRTUAL VISITS’ HAWAII Number of residents: 1.2 million Uninsured: 8.3% Healthcare Expenditures (2004): $6.2 billion Average Annual Percent Growth in Expenditures per capita (1991-2004): 5.1% Healthcare Expenditures per Capita: $4,941 Projected state budget shortfall (FY2009): About 8.6% of Hawaii’s population, or 110,000 people, are thought to have diabetes. Of those, roughly 39,000 have not yet been diagnosed, according to a report by the state health department. Among the various ethnic groups in the state, Native Hawaiians are at the greatest risk. About 12% of Native Hawaiians have been diHIGHER CANCER RATES agnosed with diabetes. At 47 deaths per Native Hawaiians, Maoris and Polyne- 100,000 people, Native Hawaiians also sians have higher rates of breast, stomach, have by far the highest mortality rate ascervical and lung cancer than whites, ac- sociated with the disease. That’s more than cording to a study in the May issue of The double the rate for Filipinos, the next highLancet Oncology. Breast, stomach and lung est group, and nearly seven times the rate for whites. Experts attribute the disparity to di erences in diet, physical activity and SOURCES OF behavioral choices. Obesity is another conCOVERAGE, tributor: nearly 75% of Native Hawaiians are overweight or obese. 2006-2007 DRUG IMPORTATION APPROVED consumers to talk to a local physician, specialist, or other healthcare provider from HMSA’s participating provider network live on-demand via the Web or by e-mail or telephone. As a part of this arrangement, all Hawaii residents will have access to Microsoft’s HealthVault platform, which allows consumers to collect, store and manage personal health information and share it with physicians, family members, and other trusted third parties. In a recent study by TNS Global, 45% of Hawaii physicians said they are extremely or very likely to deliver care using the system, and viewed convenience and improved patient care and satisfaction as key motivators to using the service. Tenminute “virtual visits” will cost between $20 and $50, according to USA Today. cancer deaths occurred in Native Hawaiian men at a rate of 145 per 100,000 deaths, compared with 117 per 100,000 deaths in white men, the study found. Among Native Hawaiian women, 123 per 100,000 deaths were from breast, stomach, cervical or lung cancer, compared with 82 per 100,000 deaths for white women. DIABETES IN HAWAII Employer 61.8% Medicare Medicaid Uninsured 12.5% 11.0% 8.3% E ective July 1, 2009, Hawaii residents will have access to I-SaveRx, a drug program that allows residents to purchase lower-cost prescription drugs from other countries. Hawaii is the sixth state to enroll in the program, which began in Illinois in 2004 and can provide savings of up to an estimated 55%. MHE HMSA will make online healthcare services available to all Hawaii residents in early 2009 through a strategic collaboration with Microsoft Corp. and American Well Inc. The 24-hour service enables Individual 3.5% Other Public 2.9% MHE Sources: Centers for Medicare & Medicaid Services; Urban Institute; Kaiser Family Foundation; U.S. Census Bureau; The Commonwealth Fund. JANUARY 2009 29

Table of Contents Feed for the Digital Edition of Managed Healthcare Executive - January 2009

Managed Healthcare Executive - January 2009 Contents Editorial Advisors For Your Benefit News Analysis Politics & Policy Letter of the Law Managed Care Outlook New Day 5 New Realities of Disease Management Pharmacy Best Practices Health Management Technology State Report: Hawaii MHE Resource Ad/Edit Index

Managed Healthcare Executive - January 2009

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