Providers

AlohaCare provides comprehensive medical and prescription drug coverage through a statewide network of contracted physicians and providers. Our network has nearly 7,000 providers to care for our members. AlohaCare’s network includes a broad range of PCPs, specialists, facility, ancillary and other providers through which members can access the full range of benefits.

A key component of our relationship with our providers is centered on our responsibility to be a good partner. With our vision of partnership, we are committed to the delivery of timely and medically-appropriate health care to our members.

Letter from our Chief Executive Officer

Aloha Lānui!  As we wrap up another year of service to Hawai`i's communities, I would like to recognize the extraordinary dedication and relentless commitment of our provider network. Thank you for responding to these unprecedented times with positivity, patience, and caring.

This was a year of growth and transition for the AlohaCare team. We currently serve 80,000 Hawai`i residents who have Medicaid and Medicare coverage. With feedback from you, our members, and community partners, we found new ways to promote operational excellence. We will continue to reach out to you to gain your valuable insight and ideas. It is our renewed commitment to you to build a strong partnership and support our members together.

As a safety net plan, we know that issues beyond the medical setting affect our members’ health. We recognize that to support your care for our members, we must address those issues that are outside of the provider’s reach. We strive to improve equal access to care, whole-person care, social determinants of health, and more robust Medicaid services.

This newsletter features our work directly with you. We also want to point out some of the programs we implemented recently that support your efforts to care for our members:

• Two initiatives were recognized by the Institute for Medicaid Innovation, a national, non-profit research and policy organization that promotes improving the lives of Medicaid enrollees through the development, implementation, and diffusion of innovative and evidence-based models of care that promote quality, value, equity, and the engagement of individuals, families, and communities:
  1. Our partnership with Tutu Bert’s house provides care management and recovery support for homeless or housing insecure members post-discharge to reduce readmissions and waitlist days.
  2. AlohaCare’s Geriatric Resources for Assessment and Care of Elders (GRACE) Program provides evidence-based care to home-bound, low income seniors with multiple chronic conditions. The program involves coordination of care for members across providers, integration of geriatric care into primary care, intensive case management, and in-home assessments. It also leverages social services to address social determinants of health needs.
• Addressing social determinants of health: It is estimated that up to 80 percent of a person’s overall health is affected by issues outside of clinical services. To strengthen our members’ ability to address social needs, AlohaCare partnered with Unite Us, which is a closed loop referral platform that can better ensure, track, and measure community referrals and outcomes. AlohaCare was the first health plan in Hawai’i to join the platform, becoming part of a statewide coordinated care network called Unite Hawaii.
• Dental, educational, and culturally responsive value-added services: In addition to food and housing programs, AlohaCare continues to make adult dental coverage a priority, developed a high school equivalency benefit, and added programs that address our communities’ unique cultural needs. We launched Ke Aloha Mau Native Hawaii Healing Services. It includes: 
  • Hula - traditional physical movement
  • Lomilomi - traditional physiotherapy and massage
  • `Ai Pono - traditional healthy food and meals
  • Ho`oponopono - traditional balancing of relationships
• Community investment: We use our small margins to re-invest in programs that engage members in their own care, improve quality of care, and support community-based organizations to provide culturally relevant and SDOH services.

On behalf of the Board, executives, and team members, I wish you a joyous, safe and healthy holiday season for you and your `ohana.

Françoise Culley-Trotman

CEO 

AlohaCare has been working hard

for you and our members!

Created in 1994, AlohaCare is a local, not-for-profit, community-governed Health Plan offering Medicaid and Medicare Advantage Plans statewide. We are the 2nd largest QUEST Integration plan and the 3rd largest health plan in Hawai’i. Our local roots and deep community ties inform how we work in Hawai’i and for Hawai’i, for you and our members.

We thank you for your partnership and collaboration in the care of our members. It takes all of us working together to build healthier communities. AlohaCare expanded our benefits, programs and services to better support your efforts to help our members on their journey towards better health.

 Expanded our value-added member benefits and services – In addition to basic adult dental services, we added new extra benefits to help our members feel their best, such as educational services to get their GED/high school equivalency diploma and traditional Native Hawaiian healing practices that include hula, lomilomi, `ai pono, and ho`oponopono.

 Provide more medication support and great pharmacy services – We’ve added a wide variety of new pharmacy options like our new ZipDrugs program that repacks multiple medicines so it’s easier for our members to use, or a 90-day supply of medications that can be mailed or hand delivered to our members. Our pharmacy customer service is available 24/7 to assist you and our members.

 Increased access to health care through telehealth – Our AlohaCare Telehealth Connect services allow our members to connect with a doctor from a smartphone, tablet or computer, especially after-hours or over the weekend, or to a behavioral health provider to help the member deal with an emotional health issue or a rough patch.

 Supporting AlohaCare members in their neighborhood – Our health coordination team can help you take care of our members. They live in the same neighborhood as our members and have in-depth health care knowledge and innovative tools to link them to community resources.

 Organize community resources to support you better – To help you refer our members who need assistance with connecting health and social care, AlohaCare helped to bring the community resource referral system, Unite Hawai`i, to the islands. Through the Unite Hawai`i referral system, we will work with you and our members who need support and resources to address their social care needs, including housing and utilities assistance, individual and family support, clothing and household goods, money management, employment, legal assistance, and more.

 Help build healthier communities – We look for ways to help you, our members and our communities: we offer free COVID-19 vaccination education materials to pass out to your patients; we sponsor food distributions in various communities; we award community grants that promote health and improve healthcare delivery; we provide education scholarships, and; we support state policy efforts to increase access to quality, affordable health care for all communities. Please let us know how we can assist you. Call: 808-973-1650, or Toll-Free: 800-434-1002

To Our Valued Providers, Mahalo!

Your participation in AlohaCare’s Provider network means that you help to provide quality health care and comfort with aloha to almost 80,000 AlohaCare Medicaid and Medicare members statewide. Thank you! 

To support you:

• AlohaCare’s community-based health coordination staff are here to work in collaboration with you, to help coordinate care you prescribe with members, among other health care practitioners, caregivers, and community resources to deliver culturally-relevant and informed patient-centered care.
• We accommodate unique circumstances because we understand that you and our members face different challenges.
• You have a designated Provider Service Representative to support you with reliable and timely assistance when you have AlohaCare-related questions or concerns.

Please let us know how we can help you. Mahalo for partnering with AlohaCare.

Contact Us

You may contact our Provider Relations Call Center at 808-973-1650 or toll-free at 1-800-434-1002 or submit your inquiry via email to providerhelp@alohacare.org if you have any questions.

To better serve our members and providers of our corporate office on O`ahu, we created a ground floor lobby reception office. Please note the change to our address suite number:

1357 Kapi`olani Blvd., Suite G101

Honolulu HI 96814

Although our offices are still closed due to the COVID-19 pandemic, we look forward to the time when we can serve you and our members in person.