HI MEDICAID MARKET
Hawaii
monitoring
No current verified market signal.
Last verified: unavailable
Last verified: unavailable · no state-specific item
No current verified signal
Precapture is monitoring this market. No state-specific public intelligence item is currently published.
Plans in this market
Parent, plan, and program come from the plan graph. Enrollment and share use the latest CMS reported count. Operations counts are CMS MCPAR. A dollar amount is not on this page.
Plans in this market 45
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| AlohaCare | AlohaCare ABD | not reported | 5,670 (2018) | 1.6% calculated | not reported |
| AlohaCare | AlohaCare Integration (QI) | not reported | 76,631 (2021) | 18.2% calculated | not reported |
| AlohaCare | AlohaCare QUEST | not reported | 62,208 (2018) | 17.4% calculated | not reported |
| AlohaCare | AlohaCare QUEST Integration | not reported | 75,936 (2024) | 17.6% calculated | 84 appeals resolved |
| AlohaCare | AlohaCare Quest Integration (QI) | not reported | 66,893 (2020) | 18.3% calculated | not reported |
show all 45
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| not reported | HMSA QUEST Integration (QI) | not reported | 155,189 (2019) | 46.7% calculated | not reported |
| not reported | HMSA QUEST Integration (QI) | not reported | 168,279 (2020) | 46.1% calculated | not reported |
| not reported | Hawaii Medical Service Association (HMSA) (QI) | not reported | 201,064 (2021) | 47.9% calculated | not reported |
| not reported | Hawaii Medical Service Association (HMSA) QUEST Integration | not reported | 214,870 (2024) | 49.7% calculated | 1,486 appeals resolved |
| Centene | 'Ohana Community Care Services (CCS) | not reported | 5,108 (2020) | 1.4% calculated | not reported |
| Centene | 'Ohana Health Plan (QI) | not reported | 38,336 (2021) | 9.1% calculated | 412 appeals resolved |
| Centene | 'Ohana Quest Integration | not reported | 35,464 (2019) | 10.7% calculated | not reported |
| Centene | 'Ohana Quest Integration (QI) | not reported | 37,329 (2020) | 10.2% calculated | not reported |
| Centene | Ohana ABD | not reported | 19,501 (2017) | 5.3% calculated | not reported |
| Centene | Ohana ABD | not reported | 17,282 (2018) | 4.8% calculated | not reported |
| Centene | Ohana Community Care Service (BHS) | not reported | 4,918 (2017) | 1.3% calculated | not reported |
| Centene | Ohana Community Care Service (BHS) | not reported | 4,470 (2018) | 1.2% calculated | not reported |
| Centene | Ohana Health Plan QUEST | not reported | 23,782 (2017) | 6.5% calculated | not reported |
| Centene | Ohana Health Plan QUEST | not reported | 22,275 (2018) | 6.2% calculated | not reported |
| Centene | Ohana Health Plan QUEST Integration | not reported | 35,916 (2024) | 8.3% calculated | not reported |
| HMSA | HMSA ABD | not reported | 8,961 (2018) | 2.5% calculated | not reported |
| HMSA | Hawaii Medical Service Association (HMSA) QUEST | not reported | 158,087 (2018) | 44.1% calculated | not reported |
| Kaiser Permanente | Kaiser ABD | not reported | 1,804 (2018) | 0.5% calculated | not reported |
| Kaiser Permanente | Kaiser Foundation Health Plan (QI) | not reported | 45,678 (2021) | 10.9% calculated | not reported |
| Kaiser Permanente | Kaiser Foundation Health Plan QUEST Integration | not reported | 50,757 (2024) | 11.7% calculated | not reported |
| Kaiser Permanente | Kaiser Foundation Health Plan Quest Integration (QI) | not reported | 34,264 (2020) | 9.4% calculated | not reported |
| Kaiser Permanente | Kaiser Permanente QUEST | not reported | 29,288 (2018) | 8.2% calculated | 1 sanctions, 15 appeals resolved |
| UnitedHealth | UnitedHealth ABD | not reported | 21,276 (2017) | 5.8% calculated | not reported |
| UnitedHealth | UnitedHealth ABD | not reported | 20,669 (2018) | 5.8% calculated | not reported |
| UnitedHealth | UnitedHealthcare CP Quest Integration (QI) | not reported | 53,512 (2020) | 14.6% calculated | not reported |
| UnitedHealth | UnitedHealthcare Community Plan (QI) | not reported | 58,324 (2021) | 13.9% calculated | 114 appeals resolved |
| UnitedHealth | UnitedHealthcare Community Plan QUEST | not reported | 26,121 (2017) | 7.1% calculated | not reported |
| UnitedHealth | UnitedHealthcare Community Plan QUEST | not reported | 27,699 (2018) | 7.7% calculated | not reported |
| UnitedHealth | UnitedHealthcare Community Plan QUEST Integration | not reported | 54,646 (2024) | 12.6% calculated | not reported |
| not reported | AlohaCare ABD | not reported | 3,921 (2016) | 1.1% calculated | not reported |
| not reported | AlohaCare QUEST | not reported | 66,243 (2016) | 18.4% calculated | not reported |
| not reported | HMSA ABD | not reported | 6,053 (2016) | 1.7% calculated | not reported |
| not reported | Hawaii Medical Service Association (HMSA) QUEST | not reported | 156,744 (2016) | 43.6% calculated | not reported |
| not reported | Kaiser ABD | not reported | 1,368 (2016) | 0.4% calculated | not reported |
| not reported | Kaiser Permanente QUEST | not reported | 30,612 (2016) | 8.5% calculated | not reported |
| not reported | Ohana ABD | not reported | 21,538 (2016) | 6.0% calculated | not reported |
| not reported | Ohana Community Care Service (BHS) | not reported | 5,506 (2016) | 1.5% calculated | not reported |
| not reported | Ohana Health Plan QUEST | not reported | 23,310 (2016) | 6.5% calculated | not reported |
| not reported | UnitedHealth ABD | not reported | 21,599 (2016) | 6.0% calculated | not reported |
| not reported | UnitedHealthcare Community Plan QUEST | not reported | 22,901 (2016) | 6.4% calculated | not reported |
CMS reported enrollment
CMS reporting years in this file run from 2016 through 2024. Retrieved 2026-11-01. The latest reporting year is 2024, which is behind the retrieval date. Enrollment figures are the CMS cell for that reporting year. Share is calculated from CMS reported total enrollment for that state, program, and year. Precapture does not combine rows. A year missing from a trend was not reported. A plan and region with more than one CMS row in a year has no trend and no year-over-year change. The dataset says a reported 0 may not truly represent 0 when a state suppressed a small count. CMS reported.
Hawaii QUEST Integration (Comprehensive MCO + MLTSS)
Hawaii QUEST Integration (Comprehensive MCO + MLTSS) 11
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| AlohaCare ABD | AlohaCare | AlohaCare | Statewide | not reported | not reported | not reported | not reported | 2017: 5,170; 2018: 5,670 |
| AlohaCare QUEST | AlohaCare | AlohaCare | Statewide | not reported | not reported | not reported | not reported | 2017: 65,873; 2018: 62,208 |
| HMSA ABD | HMSA | HMSA | Statewide | not reported | not reported | not reported | not reported | 2017: 8,009; 2018: 8,961 |
| Hawaii Medical Service Association (HMSA) QUEST | HMSA | HMSA | Statewide | not reported | not reported | not reported | not reported | 2017: 160,470; 2018: 158,087 |
| Kaiser ABD | Kaiser Permanente | Kaiser Permanente | Oahu and Maui | not reported | not reported | not reported | not reported | 2017: 1,552; 2018: 1,804 |
show all 11
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Kaiser Permanente QUEST | Kaiser Permanente | Kaiser Permanente | Oahu and Maui | not reported | not reported | not reported | not reported | 2017: 29,151; 2018: 29,288 |
| Ohana ABD | WellCare | Centene | Statewide | not reported | not reported | not reported | not reported | 2017: 19,501; 2018: 17,282 |
| Ohana Community Care Service (BHS) | WellCare | Centene | Statewide | not reported | not reported | not reported | not reported | 2017: 4,918; 2018: 4,470 |
| Ohana Health Plan QUEST | WellCare | Centene | Statewide | not reported | not reported | not reported | not reported | 2017: 23,782; 2018: 22,275 |
| UnitedHealth ABD | UnitedHealthcare | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2017: 21,276; 2018: 20,669 |
| UnitedHealthcare Community Plan QUEST | UnitedHealthcare | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2017: 26,121; 2018: 27,699 |
Med-QUEST (Comprehensive MCO + MLTSS)
Med-QUEST (Comprehensive MCO + MLTSS) 10
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| 'Ohana Health Plan (QI) | Centene Corporation | Centene | Statewide | not reported | not reported | not reported | not reported | 2021: 38,336 |
| AlohaCare Integration (QI) | AlohaCare | AlohaCare | Statewide | not reported | not reported | not reported | not reported | 2021: 76,631 |
| AlohaCare QUEST Integration | AlohaCare | AlohaCare | Statewide | CMS reported 75,936 (2024) | 17.6% | -3,957 (-5.0%) | -0.3 pts | 2022: 81,939; 2023: 79,893; 2024: 75,936 |
| Hawaii Medical Service Association (HMSA) (QI) | An Independent Licensee of the Blue Cross and Blue Shield Association | An Independent Licensee of the Blue Cross and Blue Shield Association | Statewide | not reported | not reported | not reported | not reported | 2021: 201,064 |
| Hawaii Medical Service Association (HMSA) QUEST Integration | An Independent Licensee of the Blue Cross and Blue Shield Association | An Independent Licensee of the Blue Cross and Blue Shield Association | Statewide | CMS reported 214,870 (2024) | 49.7% | -4,379 (-2.0%) | +0.6 pts | 2022: 218,177; 2023: 219,249; 2024: 214,870 |
show all 10
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Kaiser Foundation Health Plan (QI) | Based on a relationship between the Kaiser Foundation Health Plan and the Hawaii Permanente Medical Group of physicians and specialists | Kaiser Permanente | Islands of Oahu and Maui | not reported | not reported | not reported | not reported | 2021: 45,678 |
| Kaiser Foundation Health Plan QUEST Integration | Based on a relationship between the Kaiser Foundation Health Plan and the Hawaii Permanente Medical Group of physicians and specialists | Kaiser Permanente | Maui and Oahu | CMS reported 50,757 (2024) | 11.7% | -331 (-0.6%) | +0.3 pts | 2022: 50,301; 2023: 51,088; 2024: 50,757 |
| Ohana Health Plan QUEST Integration | Centene Corporation | Centene | Statewide | CMS reported 35,916 (2024) | 8.3% | -1,997 (-5.3%) | -0.2 pts | 2022: 39,592; 2023: 37,913; 2024: 35,916 |
| UnitedHealthcare Community Plan (QI) | UnitedHealthcare Insurance Company | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2021: 58,324 |
| UnitedHealthcare Community Plan QUEST Integration | UnitedHealthcare Insurance Company | UnitedHealth | Statewide | CMS reported 54,646 (2024) | 12.6% | -3,950 (-6.7%) | -0.5 pts | 2022: 60,150; 2023: 58,596; 2024: 54,646 |
MedQUEST (Comprehensive MCO + MLTSS)
MedQUEST (Comprehensive MCO + MLTSS) 7
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| 'Ohana Community Care Services (CCS) | WellCare Health Insurance of Arizona, Inc., a subsidiary of WellCare Health Plans, Inc. | Centene | Statewide | not reported | not reported | not reported | not reported | 2019: 4,463; 2020: 5,108 |
| 'Ohana Quest Integration (QI) | WellCare Health Insurance of Arizona, Inc., a subsidiary of WellCare Health Plans, Inc. | Centene | Statewide | not reported | not reported | not reported | not reported | 2020: 37,329 |
| 'Ohana Quest Integration | WellCare Health Insurance of Arizona, Inc., a subsidiary of WellCare Health Plans, Inc. | Centene | Statewide | not reported | not reported | not reported | not reported | 2019: 35,464 |
| AlohaCare Quest Integration (QI) | AlohaCare | AlohaCare | Statewide | not reported | not reported | not reported | not reported | 2019: 60,848; 2020: 66,893 |
| HMSA QUEST Integration (QI) | An Independent Licensee of the Blue Cross and Blue Shield Association. | An Independent Licensee of the Blue Cross and Blue Shield Association | Statewide | not reported | not reported | not reported | not reported | 2019: 155,189; 2020: 168,279 |
show all 7
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Kaiser Foundation Health Plan Quest Integration (QI) | Based on a relationship between the Kaiser Foundation Health Plan and the Hawaii Permanente Medical Group of physicians and specialists. | Kaiser Permanente | Islands of Maui and Oahu | not reported | not reported | not reported | not reported | 2019: 29,536; 2020: 34,264 |
| UnitedHealthcare CP Quest Integration (QI) | UnitedHealthcare Insurance Company | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2019: 46,725; 2020: 53,512 |
QUEST Integration (Comprehensive MCO)
QUEST Integration (Comprehensive MCO) 11
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| AlohaCare ABD | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 3,921 |
| AlohaCare QUEST | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 66,243 |
| HMSA ABD | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 6,053 |
| Hawaii Medical Service Association (HMSA) QUEST | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 156,744 |
| Kaiser ABD | not reported | unmatched | Oahu and Maui | not reported | not reported | not reported | not reported | 2016: 1,368 |
show all 11
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Kaiser Permanente QUEST | not reported | unmatched | Oahu and Maui | not reported | not reported | not reported | not reported | 2016: 30,612 |
| Ohana ABD | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 21,538 |
| Ohana Community Care Service (BHS) | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 5,506 |
| Ohana Health Plan QUEST | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 23,310 |
| UnitedHealth ABD | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 21,599 |
| UnitedHealthcare Community Plan QUEST | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 22,901 |
Plan operations (CMS MCPAR)
Counts, rates, dates, and status are the CMS MCPAR cells for that plan, program, and reporting year. The appeal rate is calculated from CMS reported appeals resolved in favor of the enrollee divided by CMS reported appeals resolved. It is not a CMS-published rate. A plan links when the name matches one enrollment plan in that same state and program. Unmatched is shown and is not guessed. A sanction amount is not on this page. Retrieved 2026-11-02. CMS MCPAR.
National plan operations · Federal compliance deadlines
Appeals, grievances, and enrollment share (2024)
Appeals, grievances, and enrollment share (2024) 6
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| WellCare Health Insurance of Arizona, Inc., dba 'Ohana Health Plan, Inc. | Centene | 2023_Community Care Services (CCS) Program | 22 | not reported | not reported | 65 | 100% | 100% |
| AlohaCare | AlohaCare | 2024_QUEST Integration | 42 | not reported | not reported | 127 | 17.5% | 17.6% |
| HMSA | An Independent Licensee of the Blue Cross and Blue Shield Association | 2024_QUEST Integration | 783 | not reported | not reported | 294 | 49.8% | 49.8% |
| Kaiser | Kaiser Permanente | 2024_QUEST Integration | 9 | not reported | not reported | 388 | 11.7% | 11.7% |
| Ohana | Centene | 2024_QUEST Integration | 198 | not reported | not reported | 261 | 8.2% | 8.2% |
show all 6
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| United | unmatched | 2024_QUEST Integration | 136 | not reported | not reported | 405 | 12.7% | 12.7% |
Sanctions (2024)
not reported.
Award history
- QUEST Integration Managed Care RFP-MQD-2021-008: awarded. QUEST Integration Managed Care (RFP-MQD-2021-008). Status recorded from the retrieved documents: awarded. Named awardees in confirmed excerpts: AlohaCare, Hawaii Medical Service Association (HMSA), Kaiser Foundation Health Plan, Inc., UnitedHealthcare Insurance Company dba UnitedHealthcare Community Plan. Award date 2021-03-18. Contract start 2021-07-01.
Retrieved 2026-11-03. Sources and scores
Early procurement signals
No official early-procurement document has been retrieved for this state. This is not a finding that no signal exists. Early signals
Contract amendments
No official Medicaid managed-care contract amendment has been retrieved for this state. This is not a finding that no amendment exists. Contract amendments
Medicaid policy
Indiana rows are official policy instruments. Other states show only Federal Register notices of hearings on SPA disapprovals, which are a narrow slice and not waiver or SPA coverage.
Federal Register notices of hearings on SPA disapprovals are read from the Federal Register JSON API. That covers no approved SPAs, waivers, or section 1115 demonstrations.
Coverage not_collected.
No official Medicaid managed-care policy instrument has been retrieved for this state. This is not a finding that no waiver, state plan amendment, or rule exists. Medicaid policy
Federal Register SPA disapproval hearing notices (2015 or later): 0
Plan financials
No official Medicaid plan financial filing has been retrieved for this state. This is not a finding that no filing exists, and it is not a zero. Plan financials. Coverage: not_collected.
Federal compliance deadlines
Cited federal Medicaid managed care deadlines, with the Federal Register citation, the effective date, the compliance date, and the plan obligation.