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Hawaiʻi already has a law that requires timely payment of clean health care claims. HCR 137 exists because too many providers still experience harmful reimbursement delays, and those delays do real damage to local medical practices and to patient access. The resolution asks health maintenance organizations in Hawaiʻi to follow the State’s Clean Claims Statute and to be held accountable when they do not. The resolution itself states that delayed reimbursement harms health care

Hawaiʻi’s physician shortage is often framed as a pipeline problem. The discussion usually focuses on how many doctors are trained, recruited, or retained. While workforce expansion is important, this framing overlooks a critical and immediate opportunity. A substantial portion of physician capacity is already being lost, not due to lack of clinicians, but due to administrative burden, fragmented systems, and inefficient workflows. What is administrative burden in healthcare?

Hawaiʻi’s healthcare crisis is frequently described as a workforce shortage. The most recent statewide physician workforce analysis estimates that Hawaiʻi faces a deficit of more than 800 physicians when geographic distribution and service demand are considered. That assessment is accurate. Yet it is incomplete. Recruitment alone cannot stabilize Hawaiʻi’s healthcare system if the operational environment into which physicians enter remains structurally fragile. Across islands

Policy is abstract until it touches a person. For Hawaiʻi, the convergence of ACCESS, AHEAD, and the Rural Health Transformation Grants is not primarily about payment reform. It is about whether a kūpuna in Kaʻū can see a doctor without boarding a plane, whether a working parent in Hāna can get same-week care, and whether a child on Molokaʻi grows up with a stable primary care physician who knows their story. Hawaiʻi is experiencing a rare alignment in federal policy. ACCESS,

The last time I sat down and really talked with my pediatrician, we were not in an exam room. We were sitting in the grass at the 4-H fair. I was twenty-six years old. He had been my doctor from age three to eighteen, and when he saw me, he still knew exactly who I was. Before coming to our small town, he had worked as an epidemiologist in Africa. He returned and chose pediatrics. For decades he cared for a generation of children. He treated asthma, stitched lacerations, trac

In Hawaiʻi, the healthcare workforce represents a fragile and overstretched reality rather than an abstract policy issue. The removal of even a single clinician from practice has significant consequences, particularly in rural communities where healthcare access is already limited and the margin for disruption is minimal. This bill proposes a practical update to Hawaiʻi law by permitting actively practicing Advanced Practice Registered Nurses (APRNs) to claim the same jury du

As a primary care doctor, I sometimes feel a reflexive weariness when yet another study is published concluding that we should spend more on primary care. Study after study has made the same point for decades: strong primary care improves health outcomes, advances equity, and lowers overall health care costs. The evidence is clear. What has been missing is not proof, but a practical way to turn that evidence into durable change. What makes the 2025 Primary Care Investment Gui

Although national scorecards consistently rank Hawaiʻi as having the best healthcare, citing long life expectancy, low uninsured rates, and efficient healthcare spending, these metrics obscure significant challenges. Many families lack access to primary care, mothers are often required to deliver on other islands, and hospitals frequently face staffing shortages. This contradiction is longstanding and originates from the limitations inherent in the data collection methods. Th

Prior authorization has become one of the most misapplied tools in modern medicine. In Hawaii, where we already face severe provider shortages, high administrative burdens, and limited rural access, the overuse of prior authorization magnifies the crisis. Physicians are required to submit layers of documentation to automated systems that do not reflect the clinical realities of caring for patients in the most geographically isolated state in the nation. The Hawaii Healthcare

Primary care constitutes the segment of healthcare focused on maintaining wellness, rather than intervening only after illness occurs. It encompasses prevention, early intervention, and long-term management. Despite its importance, primary care has been chronically underfunded in the United States, a trend that is particularly pronounced in Hawaiʻi. Data from the CMS Limited Data Set, as analyzed by Westat, indicate that primary care spending per beneficiary aged 65 and older

By Dr. Esther Smith Editor’s Note: This article is part of the Hawai‘i Provider Shortage Crisis Task Force’s ongoing series examining policies that influence healthcare access and equity across the islands. Dr. Esther Smith analyzes how federal spending regulations, initially intended to protect patients, may inadvertently contribute to Hawai‘i’s worsening provider shortage. Ensuring Care, Not Overhead The Affordable Care Act established the Medical Loss Ratio (MLR) , mandati

When Hawai‘i sought to expand its screen industry, lawmakers implemented a predictable incentive: 22% on O‘ahu, 27% on Neighbor Islands, with a $50 million annual cap and a $17 million per-production cap. This approach generated jobs, spending, and tax revenue. In 2023 alone, productions claiming Hawai‘i’s film credit (25 projects) reported $37.3 million in credits. DBEDT’s own analysis estimates that every $1 in credit  generates $4.00 in state GDP  (or $2.50  under a conser

Dr. Kaohimanu Dang Akiona The Hawaii Medical Association typically confers its President’s Award in recognition of a physician’s lifetime of visible achievement. In the case of Dr. Kaohimanu Dang Akiona, the award recognizes her dedicated service in underserved areas and her tireless advocacy for enhanced healthcare standards for local communities. Dr. Akiona initially trained as a researcher and subsequently developed community health programs, including a cancer patient nav

The recent Nitta ruling highlights the significant imbalance in Hawaii's healthcare contracting system. In this case, physicians argued...

Hawai‘i is blessed with extraordinary natural beauty and a strong sense of community, but our healthcare system faces challenges as vast...

Hawaii’s physician shortage worsens as independent practices struggle to survive. In Hawaii’s rural communities from Kaʻū to Hāna to...

Few terms in healthcare policy carry as much weight or baggage as the "Physician Fee Schedule" (PFS). Maintained by the Centers for...

FOR IMMEDIATE RELEASE June 15, 2025 Contact: info@hawaiihealthcaretaskforce.org Hawaii Healthcare Task Force 1003 Bishop St., Suite 1260...

A legal challenge exposes how one-sided contract terms and restrictive arbitration clauses threaten Hawaii’s provider workforce and...