State Report: Hawaii

January 1, 2009

Commonwealth Fund Performance Ranking: 1

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 office 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.

HAWAIIANS USE 'VIRTUAL VISITS'

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 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. Ten-minute "virtual visits" will cost between $20 and $50, according to USA Today.

HIGHER CANCER RATES

Native Hawaiians, Maoris and Polynesians have higher rates of breast, stomach, cervical and lung cancer than whites, according to a study in the May issue of The Lancet Oncology. Breast, stomach and lung 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

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 diagnosed with diabetes. At 47 deaths per 100,000 people, Native Hawaiians also have by far the highest mortality rate associated with the disease. That's more than double the rate for Filipinos, the next highest group, and nearly seven times the rate for whites. Experts attribute the disparity to differences in diet, physical activity and behavioral choices. Obesity is another contributor: nearly 75% of Native Hawaiians are overweight or obese.

DRUG IMPORTATION APPROVED

Effective 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 Sources: Centers for Medicare & Medicaid Services; Urban Institute; Kaiser Family Foundation; U.S. Census Bureau; The Commonwealth Fund.