Hawaii Joins the Brigade of Blue States Socking It to the Rich
Privacy protections are key to establishing public trust in mileage-based user fees
KIUC 2nd Highest in State in Renewable Generation for 2025
$110K Pay Cut: HMSA Whipsaws Doctors to Push Them into HPH
CB: …. After using a capitation payment model for nearly a decade, HMSA plans to switch back to a fee-for-service model for primary care doctors….
Starting on July 1, the insurer will stop paying a set monthly fee for each patient under a doctor’s care and revert to the way it paid doctors a decade ago: fees for individual services rendered. While some doctors preferred the older model, the rapid change to a system many had already adapted to is destabilizing — particularly for smaller practices operating on thin margins already.
For Dr Min, the change is an unwelcome surprise. She not only estimates she’ll lose $50,000 to $75,000 annually for her practice, but it comes on the heels of a $35,000 drop in Medicare reimbursements in September….
(DO THE MATH: $75K + $35K = $110K pay cut.)
One of the state’s top medical officials said he’s gotten more than 100 calls from doctors alarmed by HMSA’s announcement. The president of Hawaiʻi’s doctors’ association calls it a major change with short notice….
Kaleo Correa is a nurse practitioner who runs Waimea Primary Care on Hawaiʻi island. Her practice cares for more than 1,800 patients, she said, about half of whom are Native Hawaiian. She’s written a comprehensive critique of HMSA’s change to its payment model.
“Its sole function,” she says, “is to create economic duress that destabilizes independent practices prior to corporate consolidation.”…
Correa said financially distressed doctors may feel pressured to seek employment with – and bring their patients to – the Hawaiʻi Pacific Health Medical Group or another medical group, rather than staying on their own. …
Correa says, HMSA’s abrupt change amounts to an act of bad faith – and one that could benefit Hawaiʻi Pacific Health ahead of the proposed One Health deal.
“While executives verbally sympathize with independent clinics, HPH’s corporate growth strategy depends directly on those clinics failing,” Correa says. “Once those practices face financial ruin, HPH can step in as a ‘savior’ — offering to buy out the bankrupt clinics, absorbing the doctors as corporate employees, and folding their patient panels directly into HPH facilities.” …
(for the last decade) This model is (was) central to One Health’s vision of “risk-sharing” and “value-based care.” The idea is (was) to give doctors an incentive to keep patients healthy rather than churning them through needless office visits simply to rack up reimbursements.
(CLUE: HMSA saw the $35K Medicaid cuts and realized they could pile on another big cut to force independent doctors into being HPH employees.)
In order to make ends meet under this so-called capitated payment model, doctors must have large panels of patients, typically around 1,500 to 2,000 or more under their care, while also dealing with the administrative burden of tracking value-based care performance metrics.
While some providers have complained about this payment model, Hawaiʻi Pacific Health has said it works, keeping doctors happy and patients healthy. In fact, One Health plans to use an expanded, “global capitation” model, which would apply not only to primary care doctors, but also to specialists.
As proof the concept will work, Hawaiʻi Pacific Health’s chief executive, Ray Vara, has pointed to Hawaiʻi Health Partners, HPH’s doctors group, which Min and Correa are members of.
Hawaiʻi Health Partners has been working under a global capitation payment system with HMSA for years, and it’s saved money while improving outcomes for patients, Vara has said.
But (suddenly) Smith said the payment model isn’t working for HMSA.
In a letter dated May 1, HMSA notified primary care doctors that it would switch to a radically different payment model, known as fee for service, effective July 1. HMSA will start paying doctors based on office visits by patients rather than capped monthly allowances.
That means primary care doctors who adapted to the monthly allowance payment model suddenly will have to pivot to something entirely different….
RELATED:
Read … HMSA's Latest Move Could Worsen Doctor Shortage - Honolulu Civil Beat
Oahu traffic cameras would increase under bill before Green
SA: … Oahu drivers could see as many as 10 new red-light or speed cameras each year through a program that already has generated $763,000 since 2022.
A bill sent to Gov. Josh Green on May 8 would expand Oahu’s current 10 automated traffic cameras to no more than 10 additional locations each year and no more than two new locations in any single state senatorial district….
Senate Bill 3157 would keep automated speed enforcement and red-light camera programs limited to counties with populations of 500,000 or more, which means Oahu.
The measure also would allow speed cameras at high-risk locations on state or county highways, based on studies, instead of limiting them to locations where red-light cameras are already operating….
Read … Oahu traffic cameras would increase under bill before Green
City-owned plantation homes crumbling in Ewa Villages
HNN: … Seven city-owned plantation homes are deteriorating in Ewa Villages while the city and state struggle to provide affordable housing.
The houses were part of the Ewa plantation renovation project that promised affordable housing in renovated plantation homes.
Albert Charlton has been living next to one of the deteriorating plantation houses for 30 years. The house began falling apart after the elderly residents left.
The city did not fix it or find a new tenant….
From the start, the project was plagued by optimistic expectations and underestimated costs. City housing manager Michael Kahapea was convicted of stealing millions in business relocation expenses.
The scandal led the city to get out of the housing business entirely until Mayor Blangiardi formed a new housing and land management department a year and a half ago….
“It would absolutely be in the best interest of the public and the city if we could clear them out and sell them and put them to bed,” Auger said.
Auger says the process of selling could take another year.
“The City and County, the mayor, is the worst neighbor I’ve ever had in my life,” Charlton said….
Read … City-owned plantation homes crumbling in Ewa Villages | Hawaii News Now
Chronic No Shows And Tardiness Plague Hawaiʻi County Council
CB: … To address no shows at their meetings, the Hawaiʻi County Council adopted a measure to tighten up the definition of unexcused absences, giving the chair greater power to decide when to dock pay.
Only three council members — James Hustace, Jennifer Kagiwada and Dennis Onishi — attended every council meeting in the 15 months between January 2025 and this April. Council Chair Holeka Inaba, who introduced the resolution, said he decided to write the new rules after a reporter contacted him about absences….
Read … Chronic No Shows And Tardiness Plague Hawaiʻi County Council - Honolulu Civil Beat
Hawaiʻi Ranchers Selling Cattle to Mainland In Record Numbers
CB: … Nearly 55,000 shipments of cattle have been made from the islands in the past three years and almost 80% of those were headed out of Hawai‘i, according to state agricultural statistics. That’s more than 75% of the total number of loads of farm animals transported from and within the state.
The numbers, according to the Department of Agriculture and Biosecurity, reflect national economic trends. That includes spikes in the price of beef and surging demand from the mainland U.S. and a general lack of infrastructure in the islands to be able to get meat into the local market. The numbers also show cattle’s continued domination of the state’s livestock sector….
Read … Hawaiʻi Is Sending These Animals To The Mainland In Record Numbers - Honolulu Civil Beat
MEMORIAL DAY:
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‘Some did not come home’: Speakers reflect on meaning of service as community honors fallen veterans - Hawaii Tribune-Herald
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Gov. Green, military leaders honor fallen service members at Memorial Day ceremony | Hawaii News Now
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Filipino American veteran reflects on Gulf War, Hurricane Iniki service ahead of Memorial Day : Kauai Now
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Long-overlooked Japanese American WWII soldier honored with posthumous commission | Hawaii News Now
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Lanai Culture and Heritage Center leads Memorial Day cemetery tribute | Hawaii News Now
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‘We honor you every day’: Thousands expected at Shinnyo lantern floating ceremony
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Hawaiʻi Lantern Ceremony Is Antidote To Grief And Loss - Honolulu Civil Beat
LEGISLATIVE AGENDA:
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Big Q: Should unauthorized beach-erosion barriers on the North Shore be dismantled? | Honolulu Star-Advertiser
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Listen: Ali Velshi on The Hawaiian Bill Fighting Citizens United
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Letter: OHA must get priorities in order for Hawaiians | Honolulu Star-Advertiser
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Hawaiian Electric Overuses Confidentiality to Restrict Public involvement | Ililani Media
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Draft EA Published for New Volcano School Campus – Big Island Video News
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Management plan of polluted Hilo Bay watershed moving forward with $2 million federal grant : Big Island Now
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Disaster recovery should not be complicated by politics
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Denby Fawcett: Governor Plans To Fix Bill That Threatened Park Programs - Honolulu Civil Beat
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Hawaii County moves to use eminent domain to widen Puna road | Honolulu Star-Advertiser
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Column: Don’t lose sight of green fee’s goal | Honolulu Star-Advertiser
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Letter: Broken parking meters becoming serious issue | Honolulu Star-Advertiser
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