Preventive care helps mitigate rising healthcare costs in Hawaii – State of Reform

Industry experts identified initiatives to minimize inflation and rising healthcare costs 2023 Hawaii State of Reform Health Policy Conference.

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Gordon Ito, Insurance Commissioner at the Hawaii Department of Commerce and Consumers, identified several health care cost drivers. These included fragmented or uncoordinated care, unhealthy patient behavior and lifestyle, and problems with reimbursement.

“Another problem is the aging population,” Ito said. “Hawaii has one of the [country’s] oldest populations, so that’s a challenge. And it will only get worse.”

Lehau Pate, vice president of revenue cycle at The Queen’s Health System, said providers need to focus on primary and preventive care to help patients alleviate health problems before they get worse. Government smoking cessation programs are a good example, as are lung cancer mortality rates significantly decreased since 2019.

“Smoking prevalence among adults has decreased from one in five adults to one in seven,” Pate said. “And even more significant were the youth results, which dropped from 30% to 8%. That’s a huge drop. The focus must be on improving morbidity rates and the overall health of the population.”

The lack of sufficient long-term care options also makes safeguarding the health of the population a priority. Pate said the recent closure of a home healthcare facility has impacted 100 elderly patients.

“That leaves us with eight home health facilities on Oahu,” Pate said. “And most of these places have very long waiting lists. (Queen’s) keeps a lot of patients because we can’t place them in other community facilities.”

Queen’s is focused on improving ambulatory and ambulatory patient access to care to assist with preventive care services.

“We want to treat patients preventively to prevent them from ending up in the [emergency department]or [becoming] stationary or [placed] on a ventilator or life support,” Pate said. “Unfortunately, many of our patients experience non-compliance for a variety of reasons. They may not have transportation to go to their (GP).”

Queen’s also uses a Patient community navigation programwhich allows navigators to visit patients in their homes, Pate said.

“They provide training, make sure they’re on their medication, and make sure they’re taking care of their wounds so these issues don’t escalate and require a higher level of care in a higher cost environment,” she said. “We can take preventative steps to help our patients stay on this continuum of care. Then we can save a lot of costs, and they have better outcomes than ending up in the (emergency room) or inpatient treatment.”

Matt Reeves, senior vice president of clinical integration at the Hawaii Medical Service Association (HMSA), said HMDA uses value-based reimbursement to manage healthcare costs and promote healthcare prevention.

“Value-based contracts like that payment conversion The program offers primary care providers the flexibility to focus more on health and well-being,” Reeves said. “Values-based programs align incentives with desired outcomes, measured in health outcomes.”