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The Global Budget Initiative (GBI) is key to transforming healthcare in East Hawaii.  GBI aims to create a payment model which aligns the financial incentives of the hospital and primary care.  It will be a multi-payer, value based, and community led model which creates a single financial and clinical framework for providers.  Simplistically stated, GBI makes the empty hospital bed the profitable bed for everyone and also makes everyone accountable for their responsibilities.  C-PCMH, CAN, Community QA Committee, Exception Funding, and Coreo Care are all initiatives in support of the Care Model needed for a Global Budget Payment Model to be successful.  But the Care Model needs to be supported by a value and accountability-based Payment Model to be viable.

Some of the major objectives of GBI are to reduce avoidable emergency room visits and inpatient admissions, build local capacity for medical services, and create community governance for an integrated medical and social service system in East Hawaii.

Productive, initial discussions were facilitated with East Hawaii IPA, Hilo Medical Center, Med-QUEST, HMSA, Bay Clinic, and Hawaii Healthcare Association.  Pillars and goals of a model of care and payment were sketched out.  These preliminary thoughts were shared with a larger group of health plans, community providers, and community leaders before the Med-QUEST RFP procurement stopped further discussion.  There was consensus, however, to resume discussions when the situation permits.


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