HMSA delays primary care payment shift, extends transition to 2027

News admin June 9, 2026 0 Comments

HMSA delays primary care payment shift, extends transition to 2027

HONOLULU (HawaiiNewsNow) – HMSA is giving primary care physicians additional time to prepare for a major payment model transition.

The health insurer announced Friday that it will extend the transition period by six months, allowing physicians to remain under their current payment arrangement until Jan. 1, 2027, if they choose.

The decision follows discussions between HMSA, Gov. Josh Green and primary care providers about the potential impact of the changes on medical practices and patient care.

“We’ve heard the concerns raised by physicians and state leaders, and we are making this adjustment because we understand primary care is essential to Hawaii’s health care system,” said HMSA CEO Dr. Mark Mugiishi. “Our goal is to support physicians, protect continuity of care for our members, and make sure this transition is implemented in a responsible way.”

Under the updated plan, physicians can still opt into the new fee-for-service payment model beginning July 1, while those who need more time may delay the transition until next year.

HMSA said the revised plan also includes temporary financial assistance for eligible practices facing hardship related to the transition, along with support for adapting to new billing and reimbursement processes.

Green, who is also a physician, said the agreement helps address concerns from providers while maintaining access to care for patients.

“I appreciate HMSA’s willingness to listen, work with my administration, and adjust its approach,” Green said. “This agreement gives physicians more time, provides targeted support, and helps ensure patients can continue seeing the doctors they know and trust.”

HMSA said Neighbor Island primary care physicians who participate in the new model will receive payment rates that are 15% higher than the standard fee schedule to help offset the challenges of delivering care in rural communities.

The insurer said the payment model changes are intended to improve long-term sustainability, support quality care and ensure accurate documentation for state and federal health care funding programs.