Hawaiʻi Medical Service Association celebrates 85th anniversary; now serves 780,000 members

The Hawaiʻi Medical Service Association celebrates 85 years of providing access to high quality, affordable health care for its members in the state of Hawaiʻi.

The association was founded in 1938 by social workers to assist those who were unable to afford health care. Margaret Catton, a nurse, proposed to the Territorial Conference of Social Workers the creation of a nonprofit community-based organization through which members could pool their money to leverage prepaid health care coverage.

On June 1, 1938, the association opened its doors with 671 members, mostly teachers and social workers. Today, it covers more than 780,000 people.

The association has adapted to industry changes while prioritizing the health of its members. Through World War II and the catastrophic tsunami that hit Hilo on April 1, 1946 — the same day the association opened its Hawaiʻi Island office on the Hilo waterfront — the association has provided support to its members.

“Very few things last more than eight decades,” said President and CEO Mark M. Mugiishi, M.D., F.A.C.S. “The commitment of HMSA employees in making healthier lives in Hawaiʻi possible has been the cornerstone of the organization’s continued success. I appreciate their commitment to dedicating their lives to bring better health to Hawaiʻi.”

The association began contracting with Med-QUEST for Medicare-eligible members in the 1990s. In the 2010s, it implemented the Affordable Care Act and helped employers, members and providers understand the law’s complex provisions.

Most recently, the association provided COVID-19-related support to members, employers, providers and communities, totaling more than $175 million in financial relief. Over the last few years, the association has worked with its stakeholders to improve health outcomes in Hawaiʻi.

Impacts to health outcomes statewide:

• Employees: It’s nearly 1,300 employees are critical to the service offered to members, the contributions to the community, and the success of the association, including their selfless commitment during the generational pandemic impacting Hawaiʻi and the world.

• Members: Hawaiʻi Medical Service Association serves 780,000 members

• Providers: The network in Hawaiʻi contains 7,500 physicians, 28 urgent care providers, three health systems, 23 hospitals, 223 pharmacies, and nine provider organizations. Hawaiʻi Medical Service Association’s national and global Blues affiliation includes 34 plans and 110 million covered lives, 96% of all hospitals, 95% of all doctors, and 68,000 pharmacies, all in 190 countries worldwide.

• Employers: The association’s primary strategic goal for affordability benefited Hawaiʻi’s employers, the purchasers of its product, by keeping premiums relatively flat during the pandemic and lowering administrative spend to 5%, meaning that an industry leading 95 cents of every dollar went directly to health care spend.

• Government: Hawaiʻi Medical Service Association is the only health plan that has statewide coverage for all government lines of business, which includes federal plans for Medicare, the Federal Employee Program, and HMSA Plan 87, as well as state plans for QUEST Integration (Medicaid) and EUTF.

• Communities: The association has a long-standing history of supporting communities upon the pillars of social determinants of health (economic stability, education, neighborhood built environment, social context, and health care access), and stepped up in a big way between 2020-22 when Hawaiʻi needed it most, donating $6 million via the Hawaiʻi Medical Service Association Foundation and $5 million in corporate giving (for a total community investment of $11 million), earning it the distinction of Hawaiʻi Philanthropic Corporation of the Year in 2022 on National Philanthropy Day.