Hawaii Medical Service Association (HMSA) -

HealthPass (2002)

Description

HMSA is the largest provider of health care coverage in the state of Hawaii. Its HealthPass program is a comprehensive health promotion and disease prevention program available to members of the PPO and POS plan. The eligible population averages approximately 375,000 members per year and, in 2001, nearly 22,000 individuals utilized the program at least one time.

The HealthPass program was developed in 1990 as a way to introduce a preventive benefit that was both cost effective and integrated with participating providers; clinical practices. The program model incorporates the entire continuum of care with a strong emphasis on prevention and early detection. The mission includes striving to prevent and/or delay the onset of disease and provide for early detection of impactable diseases whose morbidity may be lessened with timely intervention.

This comprehensive program exceeds traditional HRA and risk reduction programs by ensuring personal contact with a health professional as well as on-going follow up with the participants and their care providers. Qualified health educators review individual findings with the participant and determine a health action plan based on the member's readiness to change. Risk-based referrals to clinical interventions are made simultaneously for such screenings as bone density, sigmoidoscopy, mammographies, etc. HealthPass is also intricately connected with community-based programs such as smoking cessation and HMSA-sponsored interventions such as disease management, health & safety programs, and health education classes.

HealthPass is the primary way that HMSA proves its commitment to prevention. "HMSA believes that prevention detection and early treatment of disease are the most effective means of maintaining and protecting good health." (HMSA 2001 Annual Report).

The program components include:

• Demand reduction strategy
• Behavior change strategy
• Annual birthday invitations
• Confidential Health Risk Assessment
• Biometric screening
• Individualized counseling
• Risk-based referrals to clinical interventions
• High risk/chronic condition interventions
• Referral to related interventions
• Regular follow-up to determine compliance
• Communication with the member's provider to ensure continuity of care
• Educational information
• Assisting members in finding a PCP

HealthPass is 100% funded by the health plan and is included in the PPO and POS Benefit Certificates. There are five locations throughout the Hawaiian islands which are staffed by Managers, Health Consultants, Medical Assistants and support staff. Program oversight is provided by the Program Director and a HealthPass advisory panel led by two Medical Directors and six community physicians.