![\"\"](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/iStock-827924850.jpg\")
<\/p>\nChanges could touch 760,000 HMSA members and their doctors.<\/p>\n
Changes could touch 760,000 HMSA members and their doctors.<\/p>\n
<\/p>\n
Getty Images<\/p>\n
In mid-January lawmakers from the Hawai\u02bbi House and Senate committees on consumer protection called in executives from HMSA and Hawai\u02bbi Pacific Health to explain their proposal to create a new system designed to address Hawai\u02bbi\u2019s health care crisis.<\/p>\n
Despite lengthy talk about \u201crisk-sharing,\u201d \u201cvalue-based care\u201d and \u201cbending the cost curve,\u201d the presentation by Hawai\u02bbi Pacific Health\u2019s chief executive, Ray Vara, and his HMSA counterpart, Dr. Mark Mugiishi, left some lawmakers with more questions than answers.<\/p>\n
\u201cIt\u2019s been a real challenge to understand,\u201d said Sen. Jarrett Keohokalole, a lawyer accustomed to parsing minutiae as chair of the Senate Commerce and Consumer Protection Committee.<\/p>\n
Keohokalole isn\u2019t alone. Doctors have also raised concerns, citing a lack of details about the proposal. And The Queen\u2019s Health Systems has said the deal could pose a threat to its existence.\u00a0\u00a0<\/p>\n
The deal, which would bring together the state\u2019s largest health insurer and one of its biggest hospital companies under a new umbrella organization called One Health, is likely to touch the lives of some 760,000 Hawai\u02bbi residents and their doctors.<\/p>\n
![\"Hawaii](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/Hawaii-Pacific-Health-Cancer-CenterA-1188x792.jpg\")
Hawai\u02bbi Pacific Health, one of the state\u2019s largest health providers, is planning a deal with HMSA, the state\u2019s largest health insurer. (Cory Lum\/Civil Beat\/2019)<\/p>\n
Vara and Mugiishi\u2019s main talking points are clear and reassuring to the general public: HMSA members will still be able to choose their own doctors, and the rate of rising insurance premiums will go down along with overall health care costs.<\/p>\n
Still, by Vara\u2019s account, the proposed deal represents a major \u201c180-degree turn in the way health care is delivered and funded.\u201d Proponents like Vara and Mugiishi say their plan is the best way to squelch rising health care costs and insurance premiums while promoting better outcomes for patients.\u00a0<\/p>\n
The alternative, Vara and Mugiishi say, is a system that\u2019s inexorably breaking down. Merely tweaking the system amounts to making stop-gap gap repairs to a car that\u2019s falling apart. Hawai\u02bbi, they said in a wide-ranging interview, needs a new car.<\/p>\n
\u201cThe system is not only ripe for change,\u201d Vara said, \u201cbut the system itself is unsustainable.\u201d\u00a0<\/p>\n
The proposal comes as Hawai\u02bbi\u2019s dominant health insurer is struggling. And so are health care providers.\u00a0<\/p>\n
In 2025, for the first time in nearly 20 years, Hawai\u02bbi Pacific Health, a nonprofit that owns Kapi\u02bbolani Medical Center for Women and Children, Pali Momi Medical Center, Straub Medical Center, Wilcox Medical Center and numerous clinics, posted an operating loss, Vara said. In fact, he said, every health system in Hawai\u02bbi lost money in 2025.<\/p>\n
The situation at HMSA is also bad. According to its two most recent financial statements, Hawai\u02bbi\u2019s largest health insurer has suffered escalating operating losses in recent years, even as premiums rise. The bottom line: medical claims are exceeding premiums, and the situation is getting worse.<\/p>\n
HMSA suffered a $117.4 million operating loss in 2024, despite raking in $4.4 billion in member premiums. The only reason it has remained in the black the last two years is because of income from investments and other sources.\u00a0<\/p>\n
![\"\"](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/809C705C-FE12-4776-8F0F-985477D2F004-3578-0000008AE4068256-1024x683.jpg\")
Ray Vara, CEO of Hawai\u02bbi Pacific Health, and state Rep. Linda Ichiyama survey an area set up as a mass vaccination center in 2021. (Stewart Yerton\/Civil Beat\/2021)<\/p>\n
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HMSA CEO Dr. Mark Mugiishi is one of the leading proponents of the proposed One Health deal. (Cory Lum\/Civil Beat\/2022) <\/p>\n
Consumers are starting to feel the existential financial stress the system faces. Self-employed workers and their families covered by Affordable Care Act plans on average saw a 26% premium increase for 2026<\/a>.\u00a0<\/p>\n Employed workers in Hawai\u02bbi have been somewhat insulated from premium increases by the state\u2019s health care law<\/a>, which requires employers to provide insurance for employees working 20 hours or more per week. Employers are feeling the cost, though, with the impacts rippling through the economy. And workers still experience trouble when it comes time to find a new primary care doctor or specialist.<\/p>\n Skeptics question the proposal, saying, among other things, that HMSA\u2019s current risk-sharing model already has contributed to Hawai\u02bbi\u2019s doctor shortage, which has diminished access to care for people throughout the state and especially on neighbor islands. Others say the deal will hurt the most vulnerable \u2014 sick, elderly and low-income patients \u2014 and the doctors and hospitals that treat them.<\/p>\n But the leaders behind the One Health proposal say the most harmful strategy would be to continue down the path Hawai\u2018i\u2019s health system is on.\u00a0<\/p>\n \u201cAnd so while there may be fear of the unknown,\u201d Vara said, \u201cquite honestly, I think the greater fear should be of the known: what we\u2019re currently experiencing.\u201d\u00a0<\/p>\n A Trust Problem <\/p>\n One Health\u2019s proponents say consumers wouldn\u2019t likely see much change, if any. Their HMSA health plan would still allow them to see anyone in the HMSA network, which would be separate from One Health.\u00a0<\/p>\n However, the One Health proposal could radically change the health care system, particularly the way insurers interact with doctors and hospitals.\u00a0\u00a0<\/p>\n The One Health proposal is not a merger \u2014 HMSA and HPH will continue as separate entities but collaborate through what they call a \u201crisk-bearing entity.\u201d HMSA members should be able to keep seeing the doctors they want, but to be part of HMSA\u2019s network, doctors outside of HPH will have to continue to negotiate separate contracts with HMSA.Other doctors and hospitals will be able to join One Health as long as they adopt its policies for sharing risk and caring for patients.Some believe Hawai\u02bbi\u2019s neediest residents could lose access to critical health care if the deal goes through.<\/p>\n Under a model people are most familiar with, insurance companies bear all of the risk: a sick patient goes to the doctor, the doctor treats the patient and then gets reimbursed by the insurer \u2013 something known as \u201cfee for service.\u201d If the doctor ends up with a lot of sick patients who need a lot of care, it falls onto the insurers.\u00a0<\/p>\n Over the past decade, HMSA has moved away from that payment system for primary care doctors. Under the current system, HMSA negotiates multi-year contracts with physicians, who are typically represented by physician organizations. Central to these contracts are so-called risk-sharing payment models<\/a>.\u00a0<\/p>\n With HMSA\u2019s risk-sharing payment model, primary care doctors in HMSA\u2019s commercial insurance network generally aren\u2019t paid a fee each time they see a patient. Instead, HMSA pays primary care doctors what amounts to a monthly allowance per patient, called capitation in medical parlance.\u00a0<\/p>\n Primary care doctors generally get about $40 per month per patient. To break even or make a profit, the doctors need 1,000 to 2,000 people under their care, so the healthy ones needing fewer visits can make up for sicker or older ones who need more visits.<\/p>\n Related to risk-sharing are care protocols, which health care professionals call \u201cvalue-based care.\u201d The concept is based on the adage that an ounce of prevention is worth a pound of cure. Doctors provide preventative care, patients stay healthy and HMSA doesn\u2019t have to pay for higher-cost procedures later.\u00a0<\/p>\n The challenge is creating a system to account for the ounces of prevention doctors are doling out. To do that, HMSA relies on quality metrics. Doctors can get much-needed bonuses for meeting HMSA\u2019s quality metric goals.<\/p>\n The current quality metric system adds costs for everyone. Insurers need costly technology and staff to track whether the doctors are meeting their quality metrics. Doctors need to submit extra paperwork to the insurer, adding what many doctors say is an enormous administrative burden.<\/p>\n Vara and Mugiishi say One Health would dramatically change that model. Risk-sharing and value-based care would remain central components. In fact, the idea is to expand the allowance-based, risk-sharing payment model beyond primary care doctors to specialists and surgeons, something known as \u201cglobal capitation<\/a>.\u201d\u00a0<\/p>\n Value-based care would also be expanded beyond primary care doctors, who Mugiishi said, represent \u201ca tiny fraction of the total health care spend.\u201d<\/p>\n \u201cMost of the spend comes from hospitals or specialists or pharmacy,\u201d Mugiishi said in an interview. \u201cNone of those are in value-based care.\u201d<\/p>\n Central to One Health, Vara and Mugiishi said, is a planned data-sharing system designed to reduce the red tape doctors face when dealing with HMSA, dramatically lowering administrative costs for both sides.The system could also reduce the need for prior authorizations from HMSA.<\/p>\n Another cost-saving measure: what Vara calls \u201ccoordination of care,\u201d which among other things, includes avoiding duplicating services and steering some outpatient surgeries from hospitals to less costly<\/a> ambulatory surgical centers<\/a>.\u00a0<\/p>\n Though often described as a merger, the new system would be open to any doctor, physician group or hospital that agrees to the overarching ideas of risk-sharing and providing value-based care to lower costs with the goal of creating a healthier community. Vara said he understands that specific payment models might not work for every doctor or hospital. The idea would be to tweak contract terms between such providers and\u00a0HMSA to account for that as long as the providers agreed to the overarching principles.\u00a0<\/p>\n \u201cEverybody will be able to latch on depending on where they\u2019re at,\u201d he said in an interview.<\/p>\n A main goal, Vara said, is to create more trust and cooperation between HMSA and the providers. Vara recognizes a natural tension between the two sides. At their core, insurers are financial institutions with duties to make sure money is paid out carefully. Providers, meanwhile, have a mission to treat people, and they want the insurers to pay for that treatment. It creates what Vara calls \u201ca natural conflict between two very important stakeholders.\u201d<\/p>\n Doctors and insurance companies are bound together by contracts but, Vara said, \u201cContracts can\u2019t really buy trust.\u201d<\/p>\n Vara likens the current level of trust between insurers like HMSA and providers like Hawai\u02bbi Pacific Health to that of a dating couple. You wouldn\u2019t share your bank account with someone you just started dating, but once you get married that usually changes.\u00a0<\/p>\n The idea is that One Health can serve as a marriage between HMSA and Hawai\u02bbi Pacific Health that anyone else can join. Central to the marriage is what Vara calls a \u201crisk-bearing entity\u201d \u2014\u00a0a separate outfit created for One Health that will allow HMSA and HPH to share patient data and collaborate on policies and procedures that they can\u2019t do through standard, arm\u2019s-length contract negotiations. Any doctor or hospital would be able to bolt on to the entity as long as they agreed to follow the entity\u2019s policies and procedures.<\/p>\n \u2018Risk-Sharing\u2019 And \u2018Value-Based Care\u2019 Worry Doctors<\/p>\n Some doctors are not convinced. Particularly worrisome to some is HMSA\u2019s monthly allowance payment model for primary care doctors, which could be expanded under One Health.\u00a0<\/p>\n As HMSA\u2019s Mugiishi sees it, primary care doctors have been satisfied with the monthly allowance model. He points to a 2024 survey conducted by HMSA that included 646 primary care doctors. It found 88% said the amount of time they get to spend with each patient has stayed the same or increased since HMSA adopted the monthly allowance system, and 75% said the system had made their practice financially the same or stronger.<\/p>\n But an independent study showed something very different.\u00a0<\/p>\n A 2022 survey of Hawai\u02bbi physicians published in the Hawai\u02bbi Journal of Health and Social Welfare<\/a> found that 77% of the 250 doctors who responded were unhappy with the payment model, with 55.2% reporting they were \u201cvery unhappy.\u201d The study built on a previous, similar study that shared an overarching finding: that HMSA\u2019s risk-sharing payment system was worsening Hawai\u02bbi\u2019s physician shortage.<\/p>\n Dr. Nadine Tenn Salle<\/a> is a pediatrician who represents doctors as president of the Hawai\u02bbi Medical Association. In a statement, she said the organization hasn\u2019t taken a position on the One Health deal. But she said HMSA\u2019s monthly allowance-based model has led many physicians to \u201creport increased administrative burden, uncompensated work, and rising stress \u2014 all of which have contributed to workforce strain.\u201d<\/p>\n \u201cIf HMSA is now describing itself as being in a financially unsustainable position after years of operating under this model,\u201d she added, \u201cit raises an important question: why would we expand a model that has struggled in primary care to specialists and across the broader health system without first understanding what didn\u2019t work and why?\u201d<\/p>\n Meanwhile, for some doctors, \u201cvalue-based care\u201d translates simply to onerous administrative work.<\/p>\n Dr. Curtis Takemoto-Gentile cut ties with HMSA in January, opting to ditch insurance entirely and transition to a direct primary care model in which patients pay him $200 per month to be part of his practice, which he shares with his daughter, Dr. Krishanna Takemoto-Gentile.\u00a0<\/p>\n Dr. Curtis Takemoto-Gentile recalls when HMSA first started its monthly allowance payment model about eight years ago, the insurer paid him $45 per month. HMSA later cut that to $44. And he says he was relatively lucky: some doctors, he said, were paid as little as $18 per patient per month.<\/p>\n On top of the strict budget was the administrative burden of documenting that he was meeting HMSA\u2019s quality metrics, something he says ate into nights and weekends. Making matters worse, Takemoto-Gentile says, he would have done all the things HMSA required him to do and document anyway.<\/p>\n \u201cWhy are we going through this paperwork to show that 80% of our patients got colonoscopies?\u201d \u00a0<\/p>\n Dr. Curtis Takemoto-Gentile<\/p>\n \u201cWhy are we going through this paperwork to show that 80% of our patients got colonoscopies, that 80% got mammograms, that 80% got flu shots?\u201d he said.\u00a0<\/p>\n Cutting ties with HMSA has freed him from the administrative tasks, giving him more time to spend with patients. He was recently able to make his first house call in years, which he says, \u201cwas life-saving for the patient.\u201d<\/p>\n Takemoto-Gentile said he\u2019s skeptical of the idea of spreading risk-sharing and value-based care more broadly across the health system. But he said there\u2019s something equitable about applying the models to include surgeons and specialists.<\/p>\n That way, he joked, \u201ceverybody can bitch at the same time, not just the primary care docs.\u201d<\/p>\n This Doctor Says One Health Payment Model Works<\/p>\n Among doctors not complaining about the model is Dr. Dawn Miura, who\u2019s spent 35 years as a primary care doctor. For years, Miura was part of a three-doctor private practice. Although independent, Miura and her partners worked within Hawai\u02bbi Pacific Health\u2019s physician group, Hawaii Health Partners<\/a>, which Vara says has 1,700 providers.\u00a0<\/p>\n When Miura was looking for a young doctor to take over her practice a few years ago, Miura couldn\u2019t find any takers, so she strengthened her connection to Hawai\u02bbi Pacific Health by joining the Hawai\u02bbi Pacific Health Medical Group<\/a> as an employed physician.<\/p>\n Even before joining the medical group, Miura says she benefited from being part of Hawai\u02bbi Health Partners. Like Takemoto-Gentile, Miura said she wasn\u2019t a fan of HMSA\u2019s quality metric system. It was such a hassle that Miura and her partners had to hire a full-time medical assistant to deal with the paperwork required to prove she was doing routine things like pap smears, which she said \u201care part of my DNA\u201d to do.<\/p>\n When she ordered a pap smear, Miura said, it wasn\u2019t enough that the gynecologist who did the test had billed the insurer and had been paid by HMSA. Miura had to go through additional hoops to prove the test had been done.<\/p>\n \u201cYou paid for the pap smear, dude, but you can\u2019t tell that I did it?\u201d she says, recalling dealing with HMSA. \u201cAnd that\u2019s counting against me?\u201d<\/p>\n The result: \u201cI have to pay someone to call the gynecologist to ask them to fax the pap smear, to upload the pap smear to a system that doesn\u2019t always work very well and to manually enter the date of the pap smear and to attest on my behalf that I say this pap smear really got done.\u201d<\/p>\n When negotiating with HMSA on behalf of Hawai\u02bbi Health Partners, Miura says, it was enormously helpful to \u201chave Ray Vara walk in the room and say, \u2018Let\u2019s clean this up a bit.\u2019\u201d<\/p>\n It\u2019s important, she said, to have people familiar with the business of health care negotiating on behalf of doctors who are generally busy \u201cworking 70 hours a week to care for the 1,500 to 2,000 patients they\u2019re responsible for.\u201d<\/p>\n There\u2019s another feature of the Hawai\u02bbi Health Partners current contract with HMSA that Vara says bodes well for One Health. For the last several years, Vara said, Hawai\u02bbi Health Partners has been working with an allowance-based budget model for all doctors, including specialists, known as \u201cglobal capitation<\/a>.\u201d<\/p>\n Under the model, HMSA agrees to a budgeted amount to pay Hawai\u02bbi Health Partners to deliver all of its medical services for a year. At the end of the year, the budgeted amounts are reconciled with actual amounts spent. If the providers go over budget, Hawai\u02bbi Health Partners is on the hook; if Hawai\u02bbi Health Partners can serve its patients, keeping them healthy while going under budget, Hawai\u02bbi Health Partners splits the savings with HMSA and distributes the rest to the doctors.<\/p>\n For the past four years, Vara says, Hawai\u02bbi Health Partners has come under budget.<\/p>\n The doctors and other practitioners who are part of Hawai\u02bbi Health Partners, Vara said, \u201care getting performance bonuses today, this month.\u201d<\/p>\n Concerns That Most Vulnerable Will Lose Care Access<\/p>\n An overarching concern is that some patients will find it even harder to get treatments under the One Health model, particularly people who need high-cost, low-reimbursement treatments, including low-income, uninsured, Native Hawaiian and Pacific Islander patients.<\/p>\n Leaders at The Queen\u2019s Health Systems, which includes its flagship The Queen\u2019s Medical Center on O\u02bbahu, hospitals on Hawai\u02bbi island and Moloka\u02bbi, and dozens of other facilities worry that One Health will siphon away higher-reimbursement procedures that Queen\u2019s needs to cover services that it provides for the community at a loss.<\/p>\n As an example, Queen\u2019s chief executive Jason Chang points to Queen\u2019s behavioral health services. Queen\u2019s provides about 87% of Hawai\u02bbi\u2019s behavioral health beds, he said, and it\u2019s part of the system\u2019s mission to serve the people of Hawai\u02bbi as envisioned by Queen Emma when she established the hospital.\u00a0<\/p>\n Behavioral health is a money loser for Queen\u2019s, Chang said, costing the system about $15 million annually. And it\u2019s something that nobody else wants to offer. Queen\u2019s makes up for the loss with revenue from what Chang calls \u201ccore services\u201d: more complicated, higher-reimbursement areas like cardiology, orthopedics, neurology, oncology, cancer care and surgery.\u00a0<\/p>\n These services, he says, are important for not just Queen\u2019s, but all hospitals, including those owned by Hawai\u02bbi Pacific Health.\u00a0<\/p>\n \u201cI know that that\u2019s important to them, because if you look at the new Straub, they\u2019re not building a bigger emergency room, they\u2019re not putting in behavioral health services. They\u2019re not putting any more medical beds. They\u2019re putting in more ORs, more cath labs for cardiology, neurology and more ICUs. And they\u2019ve already made the investment in the cancer center.\u201d<\/p>\n The bottom line, Chang says, is that Hawai\u2018i Pacific Health is investing in profitable medical lines and will need patients to pay for the investment. Chang points to patients needing cardiac treatment as an example. Currently, Queen\u2019s and Straub are essentially in competition for referrals from doctors needing cardiac care for their patients.\u00a0<\/p>\n \u201cWe\u2019ve been able to compete for the cardiac based on our quality and our costs and our outcomes,\u201d he says.<\/p>\n But if One Health participants are encouraged by the risk-bearing entity\u2019s policies to steer cardiac patients to Straub, he says, \u201cThat\u2019s not a fair market anymore.\u201d<\/p>\n Queen\u2019s could lose not just the patients it needs to maintain its heart center<\/a>, Chang says, but also revenue it needs to support things like behavioral health services.<\/p>\n \u201cI worry about physicians in the community starting to say that \u2026 \u2018I can\u2019t survive in private practice if I don\u2019t move that way.\u201d<\/p>\n Jason Chang, CEO, The Queen\u2019s Health Systems<\/p>\n The concern is that over time, the state will see a \u201cdegradation of these services that are important to the fragile people in Hawai\u2018i.\u201d<\/p>\n Meanwhile, Chang said, he\u2019s concerned that more doctors will feel pressure to migrate to One Health\u2019s risk-bearing entity, regardless of whether they really want to \u2013 leading to even more referrals to hospitals participating in the risk-bearing entity for high-reimbursement procedures.<\/p>\n \u201cI worry about physicians in the community starting to say that, \u2018Well, it\u2019s actually more profitable for me, personally to move this way,\u2019 or \u2018I can\u2019t survive in private practice if I don\u2019t move that way,\u201d Chang said.<\/p>\n Another risk: Medical students could be steered toward One Health rather than hospitals outside the system, like Queen\u2019s, Kuakini and Castle hospitals.<\/p>\n \u201cAny new grad can be told, wow, that\u2019s way more attractive,\u201d he said. <\/p>\n Vara has responded to the idea that the risk-bearing entity\u2019s policies would disfavor Queen\u2019s by saying Queen\u2019s turned down an offer to participate near the outset, an assertion Chang has confirmed \u2013 although he says it was his predecessor, Jill Hoggard Green<\/a>, who turned down the offer.\u00a0<\/p>\n \u201cWhat we\u2019ve constantly said back to HMSA is that we believe in taking risk, and we\u2019ll take risk with you,\u201d Chang said at a forum hosted by the Hawai\u02bbi Medical Association in December. But Chang said as Queen\u2019s heard more about the model, leadership determined the risk the hospital system would need to take on under the One Health plan was potentially too great for Queen\u2019s.\u00a0<\/p>\n The deal still needs regulatory approval from the U.S. Department of Justice. At the state level, Dr. Jack Lewin, who heads the Hawai\u02bbi Department of Health\u2019s Planning and Development Agency, will have to weigh in. Lewin declined to talk specifically about the One Health deal, which will come before him.\u00a0<\/p>\n But, he said, generally that there\u2019s nothing wrong with a capitated, monthly allowance per-patient payment model, as long as the payment is adequate to cover the doctors\u2019 costs of doing business \u2013 which he said it generally doesn\u2019t.<\/p>\n Nonetheless, he said, a lot of doctors just want a model where they can simply treat patients as needed and get paid.<\/p>\n \u201cThe older guard of my fellow physicians,\u201d he said, \u201care going to say, \u2018Pay us a fee for service and shut up.\u2019\u201d<\/p>\n \u201cHawai\u02bbi\u2019s Changing Economy<\/a>\u201d is supported by a grant from the\u00a0Hawai\u02bbi Community Foundation<\/a>\u00a0as part of its work to build equity for all through the CHANGE Framework.<\/p>\n","protected":false},"excerpt":{"rendered":"Changes could touch 760,000 HMSA members and their doctors. Changes could touch 760,000 HMSA members and their doctors.…\n","protected":false},"author":2,"featured_media":488257,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253],"class_list":["post-488256","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-health","tag-health-care","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/488256","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=488256"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/488256\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/488257"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=488256"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=488256"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=488256"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"Diagram](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/OneHealth-payment-final.jpg\")
The proposal calls for moving doctors to what is known as a capitation system. (April Estrellon\/Civil Beat\/2026)<\/p>\n![\"Relationship](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/OneHealth-current-final-1.jpg\")
Under the current system, doctors and hospital groups negotiate contracts individually with insurance companies like HMSA. (April Estrellon\/Civil Beat\/2026) <\/p>\n![\"\"](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/OneHealth-proposed-final2.jpg\")
The proposed deal brings together HMSA and HPH through a third entity that is meant to enable a different kind of health care delivery and payment model. (April Estrellon\/Civil Beat\/2026)<\/p>\n![\"Dr](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/Dr-Nadine-Tenn-Salle-speaks-with-LG-Josh-Green-during-presser-on-Samoa-Measle-outbreak-1024x759.jpg\")
Dr. Nadine Tenn Salle, president of the Hawai\u02bbi Medical Association, questions expanding a risk-sharing payment model that has left many primary care doctors unhappy. (Cory Lum\/Civil Beat\/2019)<\/p>\n![\"Dr.](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/260129-kf-Rural-Doctor-0026-1024x682.jpg\")
Dr. Curtis Takemoto-Gentile walks with his patient, Maureen Harnisch, in his Honolulu clinic. Takemoto-Gentile cut ties with HMSA in part because of the risk-sharing, value-based care model. (Kevin Fujii\/Civil Beat\/2026)<\/p>\n![\"The](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/The-Queens-Physicians-Office-Building-III-v3-1188x792.jpg\")
The Queen\u2019s Health Systems\u2019 CEO Jason Chang says the One Health model could undermine its ability to provide care for Hawai\u02bbi\u2019s neediest residents. (Cory Lum\/Civil Beat\/2022)<\/p>\n![\"\"](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/Jack-Lewin.png\")
Dr. Jack Lewin, who heads the Hawai\u02bbi Department of Health\u2019s Planning and Development Agency, will have to approve the deal. (Courtesy of Stony Brook University)<\/p>\n