Hawaii Rate Review Grants Award

Cycle I Grant Application Summary

Hawaii Grantee: The Hawaii Insurance Division

Award Date: August 16, 2010

Award Amount: $1,000,000

• Improve the Review Process: Hawaii currently has an extensive health insurance premium review process, but the information is not well reported. The State intends to use funds to contract for development of smart systems to support health insurance premium review activities.
• Increase Transparency and Accessibility: Hawaii will produce consumer-friendly reports on pending and completed health insurance premium filings to be made accessible on its website.
• Develop and Upgrade Technology: Hawaii will enhance its capacity for reviewing health insurance premiums, to allow for deeper analysis and reporting.

Cycle II Grant Application Summary

Hawaii Grantee: Hawaii Department of Commerce and Consumer Affairs

Award Date: September 20, 2011

Total Award: $3,000,000

Baseline Award: $3,000,000

• Improve rate filing requirements: Hawaii will provide consumers with access to Parts I and II of the preliminary justifications required by the federal rate review regulation. Part I provides consumers with a standardized web-based consumer disclosure form that helps them understand the reasons for proposed rate increases. Part II provides consumers with a brief, non-technical consumer oriented written explanation of the rate increase, intended to provide context for the quantitative information provided in Part I.
• Improve transparency and consumer interfaces: Hawaii will also enhance its Insurance Division's website to improve transparency with respect to the rate process, including making a history of rate actions by the Division and access to Parts I and II of the preliminary justifications required by the rate review regulation available to consumers. The Insurance Division will also receive public comments through letters or email.
• Hire new staff: Hawaii will create 4 new positions with Cycle II resources.
• Improve IT: Hawaii will enhance its Insurance Division's website to improve transparency with respect to the rate process, including making a history of rate actions by the Division and access to Parts I and II of the preliminary justifications required by the rate review regulation available to consumers. The Insurance Division will also receive public comments through letters or email. Hawaii is also considering a number of other related IT initiatives to enhance the collection and analysis of rate filing and other relevant health care data, such as claims data.

Cycle III Grant Application Summary

Hawaii Grantee: Hawaii Department of Commerce and Consumer Affairs

Award Date: September 23, 2013

Total Award Amount: $3,023,387

Baseline Award Amount: $2,000,000

Workload Award Amount: $623,387

Performance Award Amount: $400,000

• Establish Data Collection: With Cycle III funding, Hawaii will create an All Payers Claims Database (APCD), a database that systematically collects medical claims data from  both public and private payer sources.
• Expand and Improve Data Analysis: The Hawaii Department of Commerce and Consumer Affairs will use the data from the APCD to identify variations in and between market segments, with the ultimate goal of improving the quality of health care and lowering health care costs.
• Increase Health Pricing Transparency: Hawaii will establish a website that provides medical pricing data and fee schedules that reflect market rates and quantifies geographic variation. This website will be regularly updated with new pricing data. In addition, the website will also provide clear descriptions of the statistical methodologies used to develop the fee schedule.  In addition, Hawaii will also develop a data release policy to support the release and use of the APCD data, while protecting data security and confidentiality.

Cycle IV Grant Application Summary

Hawai’i Grantee: Executive Office of the State of Hawai’i
Award Date: September 19, 2014
Total Award: $1,179,000

• Establish or Improve Data Collection: The Executive Office of the State of Hawai’i will maintain staff positions necessary to continue establishing the Hawai’i Health Data Center, which will enhance health insurance rate review by establishing needed baseline and trend data for health care utilization and costs for health care transformation efforts.
• Expand and Improve Data Analysis: Hawai‘i will integrate data sets that will complete the establishment of the Data Center, and will increase the capacity and readiness of the Data Center to receive additional data sets that include quality and clinical information.
• Enhance Data Quality: Hawai’i will conduct data standardization and normalization. Hawai’i will verify thresholds for data file completeness, conduct quality assurance/data file validations and edit checks, and prepare algorithms for unique data supplied ID encryption methods.

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