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General Information

Non-Discrimination and Language Assistance Notice

Assessment Tools for the QUEST Integration Program

Adult LTSS Instructions
Adult LTSS Reassessment Tool
Adult LTSS Tool
Adult SHCN Instructions
Adult SHCN Reassessment Tool
Adult SHCN Tool
Child LTSS Instructions
Child LTSS Reassessment Tool
Child LTSS Tool
Child SHCN Instructions
Child SHCN Reassessment Tool
Child SHCN Tool
General Instructions for LTSS
General Instructions for SHCN
PA Tool
PA Tool Instructions
Service Plan Instructions
Service Plan
SN Tool
SNToolInstructions-FINAL.pdf
Summary of Health and Functional Assessment (HFA)

The QUEST program ended on December 31, 2014. The Med-QUEST Division’s (MQD) new program is called QUEST Integration. Please refer to the QUEST Integration section of the website for information about MQD programs after January 1, 2015.

QUEST Integration Procurement- 2013
Request for Information (RFI)
The Department of Human Services (DHS) released a Request for Information (RFI) on June 5, 2013 with responses due to DHS on June 28, 2013. Below is a link to the RFI.

RFI

DHS received responses from all types of stakeholders to include health plans, beneficiaries, providers, and advocacy organization. Below is a copy of the summary of the RFIs.

RFI summary

Request for Proposals (RFP)

The Department of Human Services, Med-QUEST Division released the Request for Proposals (RFP) for the QUEST Integration population. Below is the website that lists the RFP. Once on the website, search by RFP number. The RFP number is RFP-MQD-2014-005.

The Med-QUEST Division (MQD) awarded contracts to five health plans to provide services for the QUEST Integration program as described in RFP-MQD-2014-005. MQD awarded contracts to all of the applicants (listed below). MQD provides the following information on the record of award for RFP-MQD-2014-005.

QUEST Integration Health Plan proposals
The Department of Human Services (DHS) released a Request for Information (RFI) on June 5, 2013 with responses due to DHS on June 28, 2013. Below is a link to the RFI.

AlohaCare
HMSA QUEST
Kaiser Foundation Health Plan
‘Ohana Health Plan
United Healthcare Community Plan
Basis on which the awards were made



The State of Hawaii seeks to improve the health care and to enhance and expand coverage for persons eligible for Medicaid and Children’s Health Insurance Program (CHIP) by the most cost effective and efficient means through the QUEST Integration (QI) program with an emphasis on prevention and quality health care. (Because CHIP in Hawaii is operated as Medicaid expansion, Medicaid is used to represent both Medicaid and CHIP.) Certain other individuals ineligible for these programs due to citizenship status may be eligible for other medical assistance and served through contracted health plans. Hawaii implements its QUEST Integration program through qualified and properly licensed health plans that provide improved access and enhanced quality healthcare services to eligible Medicaid members for medically necessary medical, behavioral health, and long-term services and supports. The services are provided in a managed care environment with reimbursement to qualifying health plans based on fully risk-based capitated rates.

Originally implemented as the QUEST program in 1994, QUEST stands for:
      Quality care
      Universal access
      Efficient utilization
      Stabilizing costs, and
      Transforming the way health care is provided to QUEST members.

The QUEST program was designed in 1994 to increase access to health care and control the rate of growth in health care costs.

The QUEST program has gone through many changes since 1994 that included expanding the populations covered by QUEST. In 2009, the DHS implemented its QUEST Expanded Access (QExA) program that allowed its aged, blind, or disabled (ABD) population to also benefit from managed care.

The QUEST Integration program is a melding of several programs to include but not limited to QUEST, QUEST-ACE, QUEST-Net and QExA program into one-Statewide program providing managed care services to all of Hawaii’s Medicaid population.

The goals of the QUEST Integration program are to:

  • The goals of the QUEST Integration program are to:
  • Minimize administrative burdens, streamline access to care for enrollees with changing health status, and improve health outcomes by integrating programs and benefits;
  • Align the program with the Affordable Care Act (ACA);
  • Improve care coordination by establishing a “provider home” for members through the use of assigned primary care providers (PCPs);
  • Expand access to home and community based services (HCBS) and allow members to have a choice between institutional services and HCBS;
  • Maintain a managed care delivery system that assures access to high quality, cost-effective care that is provided whenever possible, in the members’ community, for all covered populations;
  • Establish contractual accountability among the State, the health plans and health care providers;
  • Continue the predictable and slower rate of expenditure growth associated with managed care; and
  • Expand and strengthen a sense of member responsibility and promote independence and choice among members that leads to a more appropriate utilization of the health care system.


   
© Hawaii State Med-QUEST Division 2003-2007