Primary Care Spending Target — Provider Working Session

How much of Hawaiʻi's health care dollar must reach primary care — and how the law makes it real. Saturday 12 September 2026, 4:00–4:40 PM HST, Room 314, JABSOM.

When: Saturday 12 September 2026, 4:00–4:40 PM HST

Where: Room 314, John A. Burns School of Medicine, 651 Ilalo Street, Honolulu, HI 96813

How much of Hawaiʻi's health care dollar must reach primary care — and how the law makes it real.

One subject

A primary care spending target for Hawaiʻi: how much of the health care dollar must reach primary care, and how a law defines it, measures it, phases it in and enforces it. Nothing else is on the table.

Why

The United States put about 4.7% of health spending into primary care in 2021; other high-income countries average 14%. Hawaiʻi has no target, no floor, and no requirement to measure its own share. Last session's HB 1965 tried to do twelve things at once, and the committees replaced its contents with a working group. The next bill is narrow: the target, and the machinery that makes it real. (Sources: Primary Care Development Corporation, citing the Commonwealth Fund; Milbank Memorial Fund, 2025 Primary Care Scorecard; HB 1965 and House Standing Committee Report 57-26.)

What we will do

The workbook puts fourteen decisions in front of the room: 1 Denominator · 2 Target level · 3 Phase-in and review · 4 Who is primary care · 5 Services and sites · 6 What spending counts · 7 Where the money must go · 8 Covered payers and markets · 9 Payment methods · 10 Attribution · 11 Reporting and verification · 12 Enforceable accountability · 13 Affordability guardrails · 14 Boundary of the bill — with what other states did on each, from Rhode Island to California's 15% statewide benchmark by 2034. We leave with a drafting instruction sheet counsel can work from. Where the room does not agree, the record carries the competing options and the information needed to resolve them.

Before you arrive

Read the workbook and mark your preliminary positions on the Saturday decision record (page 3). That is what makes forty minutes enough.

Ground rules (read aloud at 4:00)

Public data and statewide policy concepts only — no one describes their own contract rates, and no one coordinates anything about private reimbursement negotiations. Separate evidence from interpretation. A reporting statute, an aspirational benchmark and an enforceable payer floor are not the same thing. Narrow does not mean weak.