Tag Archives: HMSA

Last day at HMSA

HMSA EntranceThis is a photo I took almost 3 years ago as I started my new job at HMSA. On Jan. 28, 2011 this was the image I saw as I left the building drawing to a close a period in my corporate career that I can confidently say was the best experience I have ever had. I was part of an Innovation Center that was tasked with great challenges, like create a culture of innovation, help bend the cost curve for healthcare, infuse the organization with 2.0 tools like social media, help articulate a vision for the future of the company and help align the company toward some common strategic goals. These were lofty goals and at times felt very daunting. What made it all special was the team I was on. We were a team of six that were designated as the Business Innovation Support Team and we were "self directed". We had top level executive support and we reported in with updates periodically. The rest of the time we were on our own. The beauty of having a team of individuals that leveraged each others expertise, supported each other and developed a high degree of trust was a feeling uncommon in any of my previous work experiences. I had to pinch myself each day to make sure it was real. I also reminded myself each day that all good things will one day come to an end. And that day was Friday, Jan 28, 2011. In a recent news article that appeared in the Star-Advertiser, HMSA announced that 125 employees were transferring over to Healthways, a partner of HMSA focussed on care management. A bunch of us were called into a meeting on Tuesday, Jan. 25th to let us know that we were not part of the 125 moving over to Healhways and that we would continue on as HMSA. On Tuesday, it felt like we dodged a bullet. On Friday, a fellow innovator and I were summoned by our executive sponsors and were told due to the restructuring with Healhways and the fact that Healthways has already invested in an Innovation Center, HMSA would no longer be needing our services. This was obviously quite the shock. In anticipation of the Friday morning meeting I thought quite the opposite was going to happen. That we were going to be a liaison between Healthways and HMSA to foster the sharing of innovation across the two organizations. So much for my optimism. The move to transfer the 125 employees to Healthways is telling. In a joint press release it stated:
Healthways will assume responsibility for HMSA’s disease management, care management, pharmacy benefit management, and health promotion, prevention and quality improvement solutions and functions for the plan’s approximately 700,000 individual, commercial and government-sponsored members.
This aspect of HMSA, now moving over to Healthways, was a value added service provided by HMSA. Heathways can now focus on care management while HMSA continues to do what they do best, process claims. Mike Gold, COO and one of our Innovation Center's executive sponsors said in a statement:
Our new arrangement will enable us to put more focus on supporting the patient-physician relationship...
This I suspect will be leveraging IT tools to better enable the physicians to manage their patient pools, ie dashboards, patient summaries and tools to create custom views. HMSA is one of the largest IT shops in Hawaii and the information contain therein is valuable. The challenge now is making it accessible. For moment there, I thought we would be a part of HMSA's transformation but that is not the case. Our Innovation Center which started as six, grew to nine with the addition of a research, data analytics team is now down to two individuals. I wish them all the best in their future. As for me it is wide open. The outpouring of support is heartwarming. I'll start scoping out the opportunities as a soon as I finish this blog post and move on to the next chapter. It is funny how January's are like this for me, endings and new beginnings. Back in January 2008 I wrote this post. It feels like deja vu.

EUTF Open Enrollment

EUTF Open Enrollment *** In the interest of full disclosure, I am employed by HMSA and the following post will be biased toward my employer. HMSA has not paid or asked me to write this post. The above chart is from the Open Enrollment Reference Guide. The Employer-Union Health Benefit Trust Fund (EUTF) will offer Open Enrollment (OE) for health plans to all active State of Hawaii employees starting in November 2009. Open Enrollment is the time of year when employees can make a choice of what health plan they wish to have for the coming year. This is an annual process. Most of the time (and I am an example of this) when you first get hired your company will lay out its benefits choices and you setup which plan you want to go with and forget about it. Each year you are told if you don't do anything at Open Enrollment, you will rollover to your current existing plan. This is all about to change with the 65,000 active State of Hawaii workers. As described in the first option, if you currently have HMSA 90/10 PPO and you do nothing, you will get converted to HMA 90/10 PPO. HMA is a Mainland company, part of the family of I/MX family of companies based in Tempe, Arizona. If you want to stay with HMSA you will need to fill out the EC-1 form, specifically selecting HMSA.  This is very different from previous years. Action needs to be taken to stay with HMSA. I won't get into details as to why this is being handled this way. A lot of it has to do with price. Plans are different and in this OE period HMSA is offering an 80/20 PPO plan. HMSA will outline the different plans and benefits in forthcoming news releases. My intent here is to make people aware of this change. At the end of the day, each State of Hawaii employee will need to make their own decision regarding health plans based on their finances and the value their plan choice provides. I only hope that people make informed decisions and not placed in a plan because they were unaware of the change. If you have any questions please feel free to post comments here and I will personally track down the answers. If you read this post please pass it on to a fellow State employee. Mahalo!