This summer, I shared a note with all HMSA employees about why One Health Hawai‘i is necessary for our state, and why it’s necessary now. We’d also like to share that message with all of you.
Ray Vara, president and CEO of Hawai‘i Pacific Health, and I had the opportunity to speak to business leaders at the Chamber of Commerce Hawaii Business Luncheon. The purpose was to educate attendees on the potential benefits to Hawai'i of One Health Hawai‘i.
I took the opportunity to more broadly share the challenges that we’re facing in health care in Hawai‘i today, and why fundamental change is necessary.
Two things are happening at once. The amount of money that we need to pay for health care is going up, and the amount of money that we actually have to pay for it is going down.
Utilization is up. Patients are older and sicker. Drugs and therapies are more expensive. Costs are higher.
We receive our health care funding from two primary sources: the government (Medicare, Medicaid, Affordable Care Act) and employers (commercial lines of business). And due to budgetary constraints and the downstream impacts of H.R.1 (previously known as the One Big Beautiful Bill Act), government funding is decreasing, dramatically.
In our current structure, where health plans and care delivery are separate and distinct, a health plan like HMSA has three levers that we can pull to solve for the problem of increased costs with decreased government revenue:
- Pay providers less
- Charge employers more
- Reduce member benefits
All of these are ugly solutions. And ones that often result in HMSA being in the headlines of the news (and not in a good way).
It’s why we urgently need a fourth solution. One that finds another lever to manage the increasing cost of health care.
- Coordinate and manage care better.
- Align incentives for right care, right place, right time.
- Streamline administrative costs.
- Focus on prevention and healthier communities.
- Finance desired outcomes.
These are the natural results of vertical integration: structurally tying financing to the delivery of health care. That’s the vision behind One Health Hawai‘i. And it’s the change Hawai‘i needs, today.
Visit One Health Hawai‘i to learn more.
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