Kaiser Permanente Hawaii blamed higher-than-expected outside medical costs on a $9.7 million first-quarter loss.

The loss by the state’s largest health maintenance organization — both a medical provider and insurer — reverses a year-earlier profit of $9.1 million.

The HMO typically tries to keep medical care in its integrated network of employed providers. When members get out-of-network services that drives up the costs.

Kaiser collected $407.2 million in premium revenue compared with $406.9 million a year earlier, and spent $417.2 million on medical benefits for its 254,039 members, up from $398 million.

That resulted in a $10 million operating loss compared with an $8.9 million gain in the year-ago quarter. Investment gains of $300,000, up from $200,000, helped decrease the overall loss.

Kaiser established its health plan, which is celebrating 60 years in the islands, with the opening of a Honolulu hospital in 1958. Meanwhile, the health care provider is expanding primary and specialty care on Oahu, with a $60 million medical building in Kapolei slated for completion in 2021 at the corner of Kapolei Parkway and Kamokila Boulevard. The 40,000-square-foot medical office will also include prevention and wellness programs.

FIRST-QUARTER LOSS

$9.7 million

YEAR-EARLIER NET

$9.1 million