A profile of Hawaiians in the Medicaid Fee-For-Service program
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M Loke1, K T Kang-Kaulupali, L Honbo
1Department of Human Services, State of Hawai'i, Honolulu 96809-0339, USA.
Insights
Native Hawaiians in Hawaii
Area of Science:
- Health Services Research
- Health Disparities
- Public Health Policy
Background:
- In fiscal year 1999, Hawaii's Medicaid Fee-For-Service (FFS) program served approximately 39,000 individuals.
- Native Hawaiians represented a significant portion of the Medicaid FFS enrollees, with nearly 4,600 individuals identifying as Native Hawaiian or part-Hawaiian.
- The program provided healthcare services to aged, blind, disabled individuals, and children in foster care or subsidized adoptions.
Purpose of the Study:
- To analyze the utilization and expenditure patterns of the Medicaid FFS program among Native Hawaiians in Hawaii.
- To identify disparities in representation and healthcare needs within specific demographic and diagnostic categories.
- To compare the health conditions of Native Hawaiians with the overall FFS population.
Main Methods:
- Analysis of Medicaid Fee-For-Service (FFS) program enrollment and expenditure data for fiscal year 1999.
- Stratification of data by ethnicity (Native Hawaiian/part-Hawaiian), recipient category, and geographic location (neighbor islands vs. Oahu).
- Identification of leading disease states by dollar volume among the Native Hawaiian FFS population.
Main Results:
- Native Hawaiians were overrepresented in the disabled recipient category and underrepresented in the aged category within the Medicaid FFS program.
- In fiscal year 1999, healthcare services for Native Hawaiians (aged, blind, disabled) amounted to approximately $34 million, with females receiving $18.7 million.
- The leading disease states by expenditure for Native Hawaiians included Alzheimer's disease, acute cerebrovascular disease, and profound mental retardation.
Conclusions:
- Significant differences exist in the distribution of Native Hawaiians across recipient categories within Hawaii's Medicaid FFS program.
- Healthcare expenditures and leading disease states among Native Hawaiians in the FFS program highlight specific health needs within this population.
- Findings suggest a need for targeted health interventions and policy considerations for Native Hawaiians within the state's healthcare system.
Abstract:
In Hawai'i, the Medicaid Fee-For-Service (FFS) program enrolled approximately 39,000 individuals in fiscal year (FY) 1999. This program specifically provides healthcare services to enrollees classified as aged, blind, disabled, in-state foster children, and children who live out-of-state in subsidized adoptions. The total expenditure associated with this program was over $300 million in FY 1999. Nearly 4,600 enrollees in the Medicaid FFS program were self-identified as Native Hawaiians or part-Hawaiians. Although the proportion of Hawaiians in the Medicaid program was a fair representation of Hawaiians in the state, the distribution by recipient category within the program was in sharp contrast. Aged Hawaiians appeared to be under-represented in the program while disabled Hawaiians were overrepresented. Foster children and children under subsidized adoption accounted for 1% of the total Hawaiian population. Excluding the foster children and children under subsidized adoption, recipients of Hawaiian ancestry in the Medicaid FFS program (aged, blind, and disabled) obtained health care services amounting to approximately $34 million in FY 1999. Females in this population received more services, with total Medicaid payments amounting to $18.7 million. A higher proportion of Hawaiian recipients were on the neighbor islands. In this FFS Hawaiian population, the top three disease-states by dollar volume in FY 1999, were Alzheimer's disease, acute cerebrovascular disease, and profound mental retardation. A total of $3 million in services were provided to recipients with these primary disease-states. The five leading disease-states facing Hawaiians were generally comparable to those confronting the overall FFS population.
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