May 3, 2007
HMSA membership meeting focuses on quality of health care
Senior Vice President
The Hawaii Medical Service Association (HMSA) today held its Annual Membership Meeting
at the Ala Moana Hotel. In addition to a review of 2006 accomplishments and financial
results, HMSA President and CEO Robert P. Hiam discussed the health plan’s programs
and initiatives to help improve the quality of health care in the Islands.
In his remarks, Hiam said, "Quality care really means doing the right thing
at the right time in the right way. The result is the best outcome for the patient."
Using data from a landmark RAND Health Report, Hiam said, "Americans are getting
quality care only 55 percent of the time."
Quality health care not only benefits individual patients, but there is another
advantage. Hiam said, "When health care quality goes up, costs come down. PricewaterhouseCoopers
published a report called HealthCast 2020 that makes this point very clearly."
With 707,100 members, HMSA strives to maintain quality care and help keep costs
affordable for members and employers.
Three Programs to Help Improve Quality of Care
The HMSA Initiative for Innovation and Quality (HI-IQ) is an effort to transform
health care quality in Hawaii. HI-IQ is funding quality improvement projects in
Hawaii’s hospitals, and electronic medical record (EMR) systems for physicians.
With EMR systems, physicians can reach new levels of accuracy, efficiency and effectiveness.
In all, HMSA is investing $50 million in HI-IQ. The hospital portion of the initiative
will total $30 million, and the physician portion will total $20 million.
The HMSA Quality Service Recognition (QSR) program is another effort to help improve
health care quality in Hawaii. QSR is a voluntary program for participating physicians
and hospitals, and provides financial incentives for meeting national clinical quality
benchmarks in the delivery of care. In 2006, the program paid $16.9 million to 17
hospitals and 2,575 physicians.
QSR has been in place for more than eight years, and HMSA was the first health plan
in the nation to develop and implement such a pay-for-performance incentive program.
Another program aimed at improving health care quality in Hawaii is HMSA’s Care
Connection program. This disease management program helps HMSA members with chronic
conditions, like diabetes, heart disease, asthma and kidney disease, adopt healthy
lifestyles and manage their conditions. As a result, members live healthier lives,
and prevent costly complications. In 2006, HMSA provided Care Connection services
to more than 100,000 HMSA members.
Highlights of 2006 Accomplishments
HMSA reported on a variety of accomplishments, including:
- HMSA paid health care providers $1.69 billion for member services. That represents
an increase of 7.5 percent over 2005.
- HMSA processed more than 18.2 million claims. On average, HMSA processed over 72,100
claims every business day of the year.
- HMSA’s provider network contained nearly 5,000 participating physicians, dentists,
hospitals, pharmacies, and other health care providers.
- HMSA helped administer health plans for 16,500 employer groups in the state.
- HMSA member satisfaction remained very high. According to an annual survey, 96 percent
of members surveyed indicated they would choose their health plan again.
This year’s membership meeting was presided over by Chairman of the Board Allan
R. Landon, chairman of the board and CEO of Bank of Hawaii. Landon shared the podium
with Hiam and HMSA Executive Vice President, Chief Financial Officer, and Treasurer
Steve Van Ribbink. About 400 HMSA members attended the meeting.
HMSA is a nonprofit, mutual benefit association founded in Hawaii in 1938. It is
governed by a community board of directors that serves without compensation and
includes representatives from health care, business, labor, government, education,
clergy, and the community at large. It is an independent licensee of the Blue Cross
and Blue Shield Association. Nationally, HMSA and 37 other Blue Cross and Blue Shield
plans provide worldwide coverage to more than 94 million members.