On February 21, 2013, the federal Center for Medicare and Medicaid Services (CMS) awarded the State of Hawaii a $937,691 grant to continue its healthcare transformation efforts as part of the agency's State Innovations Model (SIM) initiative. This grant will fund a six-month planning process (from April 1, 2013 to October 1, 2013) to develop an implementation plan for comprehensive healthcare transformation. The resources provided by this grant will allow The Hawaii Healthcare Project to enter into Phase 2 of the initiative.
Purpose: CMS seeks “to test whether new payment and service delivery models will produce superior results when implemented in the context of a state-sponsored State Health Care Innovation Plan.” The premise upon which the initiative is based is “that Governor-sponsored, multi-payer models that have broad stakeholder input and engagement, and are set in the context of broader state innovation, will achieve sustainable delivery system transformation.…Because of the unique powers of state governments, Governors and their executive agencies, working together with key public and private stakeholders and the Centers for Medicare & Medicaid Services can accelerate community-based health system improvements, with greater sustainability and effect, to produce better results for Medicare, Medicaid, and CHIP beneficiaries.” (CMS State Innovation Models Funding Opportunity Announcement, July 2012).
While the importance of private sector stakeholders in transformation is emphasized, the project is clearly in the context of what good government can and should do to promote and enforce health care system change. Accordingly, significant engagement is needed both by the private sector and by the state agencies that are dedicated to Medicaid, public health, insurance, and workforce.
Process and Structure: In 2012, The Hawaii Healthcare Project was initiated as a public-private partnership between the Office of the Governor and healthcare industry stakeholders to transform Hawaii's healthcare system. Managed by the Hawaiʻi Institute for Public Affairs, THHP identified priorities for system change as Phase 1 of the initiative. The State Innovation Model planning process will serve as the next phase of that partnership. Work groups were formed to address the critical elements of the health care system that need to be aligned for transformation. In addition to the Steering Committee, other groups include:
Work groups will meet at least every other week to develop their plans. Because all of these elements have significant overlap, the groups will also meet in various permutations, taking in various subject matter experts as needed, and consulting with consumers and providers. The Steering committee will keep the process on track, coordinate work between groups, and oversee evaluation and communications strategies.
Timeline: April 1, 2013 to September 30, 2013.
Resources: The $937,691 grant will support nine positions that will provide project oversight and management, technical and subject matter expertise, and administrative and grants management support. Funds will also be available for professional and technical services.
Future implications: This process is intended to create the blueprint for a high quality, sustainable health care system for Hawaiʻi that supports better population health. We will be considering and recommending structures in the state to support the on-going process of transformation and innovation and, more immediately, expect our plan to be the basis for a multi-year, multi-million dollar federal planning grant.