Pioneering partnership well-positioned to transform quality of Hawaii’s health care

Transforming Hawaii’s health care system is an urgent need, with costs rising several times faster than the annual inflation rate and access to quality care uneven throughout our state, particularly in rural communities and on the neighbor islands.

While Hawaii ranks high nationally in several measures of health, our fragmented, volume-driven system leaves many groups and communities disproportionately vulnerable to preventable diseases and a general poor quality of health.

The time to act is now. The Hawaii Healthcare Project (THHP), a public-private partnership between the state and health-care industry stakeholders — including a coalition of health plans, hospitals, providers, labor unions and business and consumer advocacy groups — has been convened to initiate a paradigm shift in the way services are managed, delivered and reimbursed.

THHP’s primary goals include:

» Transforming the health delivery system by putting patients’ needs at the center of care, engaging them in the process and overcoming access barriers.

» Changing payment strategies to promote efficiency and rewarding the right patient and provider behavior, such as paying doctors for quality, not quantity, of care.

» Supporting change with health information technology and data by expanding use of electronic health records, sharing timely information with patients and doctors, and using information to address areas for improvement and measure outcomes.

» Aligning government health care policy and leverage purchasing power to serve as a catalyst for change.

Collaboration is key, so THHP is structured to ensure balanced deliberations and a comprehensive knowledge base with all stakeholders’ perspectives and expertise represented. THHP’s committees are consensus-driven. No one party can predetermine the outcome of deliberations.

During a time of limited state resources, THHP provides a great benefit without using any taxpayer funds. However, a project of this scale cannot operate without financial support. Fund- raising is essential to support this work. Fortunately, local health care organizations, which know better than anyone the urgent need to transform our system, have provided seed funding to launch this initiative. We believe our work has national implications and aims to serve as a model of transformation for other states. Therefore, fundraising efforts will now expand to national foundations and other sources.

THHP recently announced the completion of the first phase of the project. Four of its five committees have held 20-plus meetings since April to identify strategies for transformation. One of the priorities is the promotion of "patient-centered medical homes," a concept that puts the patient at the center of a team of health care providers. Others include developing resources for "community care networks" to encourage better care coordination, and encouraging the effective and widespread use of electronic health records and health information exchanges. A fifth committee will be convened shortly to assess how best to reconcile the federal Affordable Care Act, recently affirmed by the U.S. Supreme Court, and the state’s Hawaii Prepaid Health Care Act, the 1974 landmark legislation that has resulted in Hawaii having one of the nation’s lowest rates of uninsured.

As the multi-year project moves into the second phase — implementation of the strategic concepts — a robust public and stakeholder outreach effort will occur to further develop the final implementation plan, to be released later this year.

Considering the expertise and commitment of those at the table, THHP is well-positioned to transform health care in Hawaii. Locally, there are excellent examples now of dramatic improvements in quality and access to health care. Electronic connectivity, payment reform, and patients actively involved in their own care are rapidly transforming care today.

We are striving to make these successes the standard, rather than the exception, so that everyone in our islands has access to quality, affordable health care and our population as a whole can enjoy better health.