Hawaii Dabbling (Ignorantly) With DPC

Hawaii has a sad piece of legislation that contemplates DPC using the statements below.   SCR 157, SCR 159, and SCR 108 all contain the same quoted language.

"WHEREAS, the development of direct primary care or "concierge medicine," which is the practice of financing direct primary care through direct payments by consumers, usually in the form of monthly fees, and the billing of patient health insurance plans, has also grown nationally and in this State;" (Notice the statements in bold - they have confused DPC and concierge straight out of the gate.)

"BE IT RESOLVED by the Senate of the Twenty-eighth Legislature of the State of Hawaii, Regular Session of 2016, the House of Representatives concurring, that the Insurance Division of the Department of Commerce and Consumer Affairs is requested to conduct a survey of the medical professional community that identifies the extent to which:"

"Direct primary care, or "concierge medicine," has penetrated the Hawaii healthcare marketplace;" (According to our mapper this is easy - there are no DPC practices in Hawaii)

"Health care providers, in terms of their numbers and types, are participating in direct primary care, or "concierge medicine," arrangements;"

"Patients, in terms of their numbers and the type of insurance plan covering them (i.e., private insurance, Medicare, or Medicaid), are being served and provided primary care through direct primary care, or "concierge medicine," practices; and"

"Accountable care organizations and direct primary care, or "concierge medicine," have either increased or decreased the access of Medicare or Medicaid patients to primary care services in the State; and" (This is an attempt to marginalize DPC by claiming that this would worsen access problems for Medicare patients.  As we know, this is a false assumption.  DPC physicians routinely opt out specifically so that they CAN continue to see Medicare patients. Recall that Hawaii also had proposed legislation in this session that would make it illegal to not have your practice open to Medicare patients.) 

"BE IT FURTHER RESOLVED that the Insurance Division is further requested to submit a report of its findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days before the convening of the Regular Session of 2017."

For those that do not follow this issue closely.  Hawaii appears interested in DPC, but not interested enough to proffer simple "not insurance" legislation.  Instead, they are attempting to have the Department of Insurance "study" DPC and Concierge, which they inappropriately lump together.  The Department of Insurance is the LAST group that should be tasked with studying this model!  Just ask the Washington state insurance commissioner.  Their office has to reluctantly track data about DPC practices and present an annual report to the legislature.