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Hawaii

A collection of resources on health system performance in Hawaii.

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Scenic view of sea against sky, Waikane, Hawaii, United States

#2 in our 2023 State Rankings

The 2023 Scorecard on State Health System Performance identifies a range of health care system deficiencies, and how they have been exacerbated by the pandemic. See why Hawaii ranked #2 this year.

Read the Scorecard →

Featured Performance Indicators

4%

Uninsured adults
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230

Premature avoidable deaths per 100,000 population
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115

Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
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Hawaii Performance Data

Show All Performance Areas
Access to Health Care
Children
Consumer Insurance and Medical Costs
Health Care System Spending
Health Insurance Coverage
Health Status and Outcomes
Health and Reproductive Care for Women
Hospital Safety and Quality
Mental Health
Older Adults
Outpatient Safety and Quality
Post-Acute Care and Long Term Care
Potentially Avoidable Care
Preventive and Well Care
Primary Health Care
Working Age Adults
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Access to Health Care

Access to Health Care
Indicator
Latest
U.S. Avg.
Adults who went without care because of cost
6.7%
2023
11.7%
Adults with a usual source of care
86.8%
2023
82.8%
Adults with any mental illness reporting unmet need
20%
2019-20
28%
Adults with any mental illness who did not receive treatment
69%
2019-20
55%
Adults without a dental visit
28.2%
2022
36.1%
Children who received needed mental health care
82.6%
2021-22
80.6%
Children with a medical and dental preventive care visit in the past year
65.3%
2021-22
64.4%
Children with a medical home
46.1%
2021-22
44.9%
Youth with depression who did not receive mental health services
75%
2019-20
60%

Children

Children
Indicator
Latest
U.S. Avg.
Children who are overweight or obese
31.7%
2021-22
32.7%
Children who received needed mental health care
82.6%
2021-22
80.6%
Children with a medical and dental preventive care visit in the past year
65.3%
2021-22
64.4%
Children with a medical home
46.1%
2021-22
44.9%
Children with all recommended vaccines
72%
2021
72%
Infant mortality per 1,000 live births
4.7
2021
5.4
Uninsured children
2.5%
2023
5.4%
Youth with depression who did not receive mental health services
75%
2019-20
60%
Consumer Insurance and Medical Costs
Consumer Insurance and Medical Costs
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults who went without care because of cost
6.7%
2023
11.7%
Employee contribution to total premium cost for employer-sponsored health insurance plans
$4,355
2021
$4,967
Employee contribution to total premium cost for employer-sponsored health insurance plans, as a share of state median income
6%
2021
6.8%
Employee deductible for employer-sponsored health insurance plans
$2,141
2021
$3,371
Employee deductible for employer-sponsored health insurance plans, as a share of state median income
2.9%
2021
4.6%
Employee total potential out-of-pocket medical costs
$6,496
2021
$8,338
Employee total potential out-of-pocket medical costs, as a share of state median income
8.9%
2021
11.5%
Individuals with high out-of-pocket medical spending
8.8%
2021-22
10%
People with medical debt
5%
2021
12.6%
Total premium cost for employer-sponsored health insurance plans
$14,705
2021
$17,650
Total premium cost for employer-sponsored health insurance plans, as a share of state median income
20.1%
2021
24.2%
Health Care System Spending
Health Care System Spending
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Doctors' office visit employer-sponsored insurance spending per enrollee
$430
2021
$540
Doctors' office visit spending per Medicare beneficiary
$875
2021
$1,088
Home health spending per Medicare beneficiary
$171
2021
$518
Inpatient employer-sponsored insurance spending per enrollee
$1,317
2021
$1,512
Inpatient spending per Medicare beneficiary
$1,707
2021
$2,563
Primary care spending as share of total, age 65 and older
4.4%
2021
5.3%
Primary care spending as share of total, ages 18–64
5.6%
2021
6.9%
Primary care spending per beneficiary, age 65 and older
$398
2021
$621
Primary care spending per enrollee, ages 18–64
$348
2021
$558
Public health funding
$133
2019
$40
Skilled nursing facility spending per Medicare beneficiary
$519
2021
$821
Total employer-sponsored insurance spending per enrollee
$4,566
2021
$6,060
Total spending per Medicare beneficiary
$6,915
2021
$10,478
Health Insurance Coverage
Health Insurance Coverage
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Uninsured adults
3.9%
2023
11%
Uninsured children
2.5%
2023
5.4%
Uninsured women, during pregnancy
0.4%
2021
2.6%
Uninsured women, pre-conception
2.4%
2021
11.6%
Health Status and Outcomes
Health Status and Outcomes
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults who are obese
28.4%
2023
33.7%
Adults who have lost six or more teeth
4.7%
2022
8.6%
Adults who report fair or poor health
13.8%
2023
17.4%
Adults who smoke
9%
2023
11.4%
Alcohol deaths per 100,000 population
7.1
2022
13.5
All-cause mortality rate per 100,000 women ages 15–44
70.5
2022
110.3
Breast cancer deaths per 100,000 female population
18.7
2022
18.8
Children who are overweight or obese
31.7%
2021-22
32.7%
Colorectal cancer deaths per 100,000 population
12.4
2022
13
Drug overdose deaths per 100,000 population
18.6
2022
32.6
Hospital 30-day mortality
12.4%
07/2018 - 06/2021
12.3%
Infant mortality per 1,000 live births
4.7
2021
5.4
Maternal mortality per 100,000 live births
-
2020-2022
26.3
Mortality amenable to health care, deaths per 100,000 population
81.1
2019-20
86.8
Premature avoidable deaths per 100,000 population
230.1
2020-21
320.8
Premature deaths from preventable causes per 100,000 population
152
2020-21
231.9
Premature deaths from treatable causes per 100,000 population
78.2
2020-21
88.8
Public health funding
$133
2019
$40
Suicide deaths per 100,000 population
16.6
2022
14.2
Health and Reproductive Care for Women
Health and Reproductive Care for Women
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adult women who received a cervical cancer screening Pap test
76.9%
2020
75.8%
Adult women who received a mammogram
78.7%
2022
76.7%
Adult women who received a recommended cervical cancer screening test
83.1%
2022
82%
All-cause mortality rate per 100,000 women ages 15–44
70.5
2022
110.3
Breast cancer deaths per 100,000 female population
18.7
2022
18.8
Infant mortality per 1,000 live births
4.7
2021
5.4
Maternal mortality per 100,000 live births
-
2020-2022
26.3
No early prenatal care
30.4%
2022
23%
Preterm birth rate
9.8%
2022
10.4%
Recently pregnant women with a dental cleaning during pregnancy
44.6%
2021
45%
Self-pay in-hospital births
1%
2022
2.9%
Uninsured women, during pregnancy
0.4%
2021
2.6%
Uninsured women, pre-conception
2.4%
2021
11.6%
Women experiencing intimate partner violence
2%
2021
3.1%
Women who received a flu shot before or during pregnancy
60%
2021
56.7%
Women who received a postpartum depression screening
90.7%
2021
89.2%
Women with depression before or during pregnancy
13.3%
2021
21.8%
Women with postpartum depression
14.4%
2021
12.6%
Women without a postpartum checkup after birth
11.3%
2021
9.1%
Hospital Safety and Quality
Hospital Safety and Quality
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Care Transition Preparedness (out of 100 points)
51
2021
49
Central line-associated blood stream infection (CLABSI), Standardized Infection Ratio
0.573
2021
0.921
Communication about medicines (out of 100 points)
64
2021
60
Communication with doctors (out of 100 points)
81
2021
78
Communication with nurses (out of 100 points)
80
2021
78
Hospital 30-day mortality
12.4%
07/2018 - 06/2021
12.3%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiaries
16.1
2021
33.1
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
3
2021
2.9
Hospital discharge instructions for home recovery
85%
2021
86%
Hospital discharge planning and instructions for home recovery (out of 100 points)
87
2021
86
Hospitals with better-than-average patient experience ratings
55%
2021
45%
Patients' overall hospital experience (out of 100 points)
74
2021
70
Responsiveness of hospital staff (out of 100 points)
65
2021
61
Mental Health
Mental Health
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults with any mental illness reporting unmet need
20%
2019-20
28%
Adults with any mental illness who did not receive treatment
69%
2019-20
55%
Alcohol deaths per 100,000 population
7.1
2022
13.5
Antidepressant use and adherence for depression
40.3%
2021
38.2%
Children who received needed mental health care
82.6%
2021-22
80.6%
Drug overdose deaths per 100,000 population
18.6
2022
32.6
Suicide deaths per 100,000 population
16.6
2022
14.2
Women who received a postpartum depression screening
90.7%
2021
89.2%
Women with depression before or during pregnancy
13.3%
2021
21.8%
Women with postpartum depression
14.4%
2021
12.6%
Youth with depression who did not receive mental health services
75%
2019-20
60%
Older Adults
Older Adults
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
At risk adults with a recent check-up
92%
2023
91.3%
Doctors' office visit spending per Medicare beneficiary
$875
2021
$1,088
Home health patients with a hospital admission
13%
2019
15%
Home health spending per Medicare beneficiary
$171
2021
$518
Hospital 30-day mortality
12.4%
07/2018 - 06/2021
12.3%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiaries
16.1
2021
33.1
Inpatient spending per Medicare beneficiary
$1,707
2021
$2,563
Long-stay nursing home residents with a hospital admission
10%
2020
17%
Older adults who received the pneumonia vaccine
61%
2023
70.2%
Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
114.5
2021
141.3
Preventable hospitalizations age 65 and older, per 1,000 Medicare beneficiaries
15.8
2021
28.6
Primary care spending as share of total, age 65 and older
4.4%
2021
5.3%
Primary care spending per beneficiary, age 65 and older
$398
2021
$621
Short-stay nursing home residents with a 30-day readmission to the hospital
13%
2020
18%
Skilled nursing facility spending per Medicare beneficiary
$519
2021
$821
Skilled nursing patients with a successful discharge
67%
2020
57%
Total spending per Medicare beneficiary
$6,915
2021
$10,478
Outpatient Safety and Quality
Outpatient Safety and Quality
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults with low back pain with an imaging study at diagnosis
66.4%
2021
69.1%
Appropriate antibiotic among adults with bacterial pneumonia
50.2%
2021
44.3%
Post-Acute Care and Long Term Care
Post-Acute Care and Long Term Care
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Home health patients whose wounds healed after an operation
84%
2019
92%
Home health patients with a hospital admission
13%
2019
15%
Home health patients with improved mobility
73%
2019
80%
Home health spending per Medicare beneficiary
$171
2021
$518
Long-stay nursing home residents with a hospital admission
10%
2020
17%
Nursing home residents with an antipsychotic medication
8.8%
2020
14.4%
Nursing home residents with pressure sores
3.2%
2017
5.6%
Short-stay nursing home residents with a 30-day readmission to the hospital
13%
2020
18%
Skilled nursing facility spending per Medicare beneficiary
$519
2021
$821
Skilled nursing patients with a successful discharge
67%
2020
57%
Potentially Avoidable Care
Potentially Avoidable Care
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults with low back pain with an imaging study at diagnosis
66.4%
2021
69.1%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiaries
16.1
2021
33.1
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
3
2021
2.9
Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
114.5
2021
141.3
Potentially avoidable ED visits ages 18–64, per 1,000 employer coverage enrollees
135.7
2021
133.9
Preventable hospitalizations age 65 and older, per 1,000 Medicare beneficiaries
15.8
2021
28.6
Preventable hospitalizations ages 18–64, per 1,000 employer coverage enrollees
4.5
2021
4.4
Preventive and Well Care
Preventive and Well Care
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adult women who received a cervical cancer screening Pap test
76.9%
2020
75.8%
Adult women who received a mammogram
78.7%
2022
76.7%
Adult women who received a recommended cervical cancer screening test
83.1%
2022
82%
Adults ages 45–74 who received a colon cancer screening test
62.5%
2022
59.5%
Adults who received a colon cancer screening test
77.1%
2020
72.4%
Adults with a recent flu shot
44.6%
2023
42.2%
Adults with age- and gender-appropriate cancer screenings
72.6%
2020
68.8%
Adults with age- and gender-appropriate cancer screenings (2022 update)
66.5%
2022
64.6%
Adults with age-appropriate vaccines
40.2%
2023
39.3%
Adults without a dental visit
28.2%
2022
36.1%
At risk adults with a recent check-up
92%
2023
91.3%
Children with a medical and dental preventive care visit in the past year
65.3%
2021-22
64.4%
Children with all recommended vaccines
72%
2021
72%
Diabetic adults with an annual hemoglobin A1c test
90.1%
2021
90.1%
Diabetic adults with an annual LDL-C test
75.5%
2021
79.3%
Older adults who received the pneumonia vaccine
61%
2023
70.2%
Premature avoidable deaths per 100,000 population
230.1
2020-21
320.8
Premature deaths from preventable causes per 100,000 population
152
2020-21
231.9
Premature deaths from treatable causes per 100,000 population
78.2
2020-21
88.8
Primary care spending as share of total, age 65 and older
4.4%
2021
5.3%
Primary care spending as share of total, ages 18–64
5.6%
2021
6.9%
Primary care spending per beneficiary, age 65 and older
$398
2021
$621
Primary care spending per enrollee, ages 18–64
$348
2021
$558
Public health funding
$133
2019
$40
Primary Health Care
Primary Health Care
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adult women who received a cervical cancer screening Pap test
76.9%
2020
75.8%
Adult women who received a mammogram
78.7%
2022
76.7%
Adults who received a colon cancer screening test
77.1%
2020
72.4%
Adults with a usual source of care
86.8%
2023
82.8%
Adults with age- and gender-appropriate cancer screenings
72.6%
2020
68.8%
Adults with age- and gender-appropriate cancer screenings (2022 update)
66.5%
2022
64.6%
Adults with age-appropriate vaccines
40.2%
2023
39.3%
At risk adults with a recent check-up
92%
2023
91.3%
Children with a medical and dental preventive care visit in the past year
65.3%
2021-22
64.4%
Children with a medical home
46.1%
2021-22
44.9%
Children with all recommended vaccines
72%
2021
72%
Diabetic adults with an annual hemoglobin A1c test
90.1%
2021
90.1%
Diabetic adults with an annual LDL-C test
75.5%
2021
79.3%
Doctors' office visit employer-sponsored insurance spending per enrollee
$430
2021
$540
Doctors' office visit spending per Medicare beneficiary
$875
2021
$1,088
Mortality amenable to health care, deaths per 100,000 population
81.1
2019-20
86.8
Older adults who received the pneumonia vaccine
61%
2023
70.2%
Premature avoidable deaths per 100,000 population
230.1
2020-21
320.8
Premature deaths from preventable causes per 100,000 population
152
2020-21
231.9
Premature deaths from treatable causes per 100,000 population
78.2
2020-21
88.8
Primary care spending as share of total, age 65 and older
4.4%
2021
5.3%
Primary care spending as share of total, ages 18–64
5.6%
2021
6.9%
Primary care spending per beneficiary, age 65 and older
$398
2021
$621
Primary care spending per enrollee, ages 18–64
$348
2021
$558
Working Age Adults
Working Age Adults
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults who are obese
28.4%
2023
33.7%
Adults who have lost six or more teeth
4.7%
2022
8.6%
Adults with low back pain with an imaging study at diagnosis
66.4%
2021
69.1%
Antidepressant use and adherence for depression
40.3%
2021
38.2%
Appropriate antibiotic among adults with bacterial pneumonia
50.2%
2021
44.3%
Diabetic adults with an annual hemoglobin A1c test
90.1%
2021
90.1%
Diabetic adults with an annual LDL-C test
75.5%
2021
79.3%
Doctors' office visit employer-sponsored insurance spending per enrollee
$430
2021
$540
Employee contribution to total premium cost for employer-sponsored health insurance plans
$4,355
2021
$4,967
Employee contribution to total premium cost for employer-sponsored health insurance plans, as a share of state median income
6%
2021
6.8%
Employee deductible for employer-sponsored health insurance plans
$2,141
2021
$3,371
Employee deductible for employer-sponsored health insurance plans, as a share of state median income
2.9%
2021
4.6%
Employee total potential out-of-pocket medical costs
$6,496
2021
$8,338
Employee total potential out-of-pocket medical costs, as a share of state median income
8.9%
2021
11.5%
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
3
2021
2.9
Inpatient employer-sponsored insurance spending per enrollee
$1,317
2021
$1,512
Potentially avoidable ED visits ages 18–64, per 1,000 employer coverage enrollees
135.7
2021
133.9
Preventable hospitalizations ages 18–64, per 1,000 employer coverage enrollees
4.5
2021
4.4
Primary care spending as share of total, ages 18–64
5.6%
2021
6.9%
Primary care spending per enrollee, ages 18–64
$348
2021
$558
Total employer-sponsored insurance spending per enrollee
$4,566
2021
$6,060
Total premium cost for employer-sponsored health insurance plans
$14,705
2021
$17,650
Total premium cost for employer-sponsored health insurance plans, as a share of state median income
20.1%
2021
24.2%
Uninsured adults
3.9%
2023
11%
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Hawaii Policy Information

Policy
Status
Medicaid Expansion Status

Traditionally expanded Medicaid (33 states + DC)

Health Insurance Marketplace Type

Federally facilitated marketplace; state conducting plan management (13)

Public Coverage Options

Has not established a public coverage option

ACA Non-compliant Short-term Plans

Sets stricter limits on the sale of short-term coverage than the federal government

ACA Non-compliant Transitional Plans

Permits non-compliant transitional policies

Annual Open Enrollment Period Extensions

Did not extend 2018–2022 open enrollment

Health Coverage Subsidies

Provides no additional premium or cost-sharing subsidies

Other ACA Non-compliant Plans

Does not exempt other coverage from insurance rules

Promotion of ACA Marketplace Competition

No rules to promote marketplace competition

Standardized Individual Market Plans

Does not require standardized cost-sharing plan design

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Hawaii Key Demographics

1.4M
Total Population
$89.2K
Median Household Income
23%
Below 200% of Federal Poverty Level (FPL)
20%
% White race, non-Hispanic
1%
% Black race, non-Hispanic
10%
% Hispanic ethnicity
45%
% Asian American, Native Hawaiian, or Pacific Islander race, non-Hispanic
< 1%
% American Indian or Alaska Native race, non-Hispanic