HAWAII: AUDITOR SAYS QUEST RAISED STATE HEALTH COSTS
The state auditor said Monday that QUEST, "the state'sThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
controversial attempt to stem the rising cost of public health
care," has actually increased the state's health care
expenditures and has "become a management nightmare." HONOLULU
ADVERTISER reports that state auditor Marion Higa said that the
state's public health care costs have increased more than 25% in
the last two years. ADVERTISER reports that with liberal
benefits and enrollment policies, QUEST's enrollment "mushroomed
from a projected 110,000 to nearly 160,000." According to the
auditor's report, QUEST's costs for its first year, FY '94-'95,
were $276 million. However, costs jumped to $352 million the
following year, the report found.
DEFENSE: State Human Services Director Susan Chandler
agreed that QUEST experienced implementation problems, but called
the plan an "overall success," and predicted that the state would
"break even" by the end of the program's five-year demonstration
period. "We are confident that, after five years, the costs will
not have been any higher than had we not had QUEST," she said.
Chandler noted that the state's per-person annual health care
costs have dropped from $197 to $190 for FY '95-'96, and said
that costs are expected to drop to $170 for the current fiscal
year. ADVERTISER reports that QUEST has "tightened its
eligibility requirements ... and has required more members to
share the cost of their premiums."
EVEN STEVEN: However, Higa said that "breaking even is a
far cry from the $400 million" in savings that the state
predicted it would realize when it introduced the plan. In
addition, she said that the Med-QUEST division of the program is
"understaffed and underfunded" and may be out of compliance with
the federal waiver it received to operate. However, Chandler
said, "We talk to (federal officials) every other week in
Washington and California. ... There has never been any
discussion that they are worried we are out of compliance." But
Higa recommended that the state not implement the next phase of
QUEST, "which will bring about 13,000 disabled and elderly people
into the program."
DATA PLEASE: Higa also said the QUEST program has failed to
develop a coordinated system to evaluate cost data. State Rep.
Dennis Arakaki (D) said, "The Legislature needs to demand some
real data and outcome of how this program has either maintained
or improved the health of low-income people." Chandler said that
an evaluation system should be ready shortly and that "her
department has pieced together enough data to evaluate the
program" (Miller, 12/17).