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2025 Annual Report

A message from our CEO and chair

 

Aloha,

In Hawaii and across the U.S., health care affordability and access remain the most pressing challenges and opportunities. In spite of the headwinds we face in our industry, we remain focused on investing in programs and initiatives that support the long-term sustainability of our health plans. Our aim is to make the necessary improvements to serve our members, employers, and the people of Hawaii for generations to come. In 2025, we continued our evolution by focusing on the following key priorities:

Deepening our relationships with all provider partners across all our networks.

Stabilizing our financial and operational performance.

Pursuing partnerships that enable scale so we can continue to deliver value and improve outcomes for our members.

A key part of this work is One Health Hawaii, our proposed partnership with Hawaii Pacific Health. By bringing together two mission-driven, local, not-for-profit organizations, we have an opportunity to work more closely with providers, improve coordination, and create a more efficient and sustainable health care system for Hawaii. This partnership reflects our shared commitment to improving affordability and strengthening care delivery so we can better serve our members, patients, and communities across the state.

We announced Jenny Smith as our new president and chief operating officer, effective Nov. 1, 2025. An experienced and thoughtful health care executive and the organization’s first woman president, Jenny brings a wealth of experience and expertise in driving health plan performance. Under Jenny’s operational leadership, we look forward to continued progress in 2026.

In 2025, we also focused on using technology to improve affordability, patient experience, population health, health equity, and provider well-being. Through a partnership with like-minded Blue Cross Blue Shield plans, we’re investing in Stellarus, an innovative technology platform driven by artificial intelligence to provide access to smarter, more personalized care.

Reflecting on our progress and the path forward, we’re deeply appreciative of our partners and the trust placed in us by our members and community. We look ahead with purpose, focused on building a stronger health care system for the future.

Signature of Mark Mugiishi

Mark M. Mugiishi, M.D., F.A.C.S.
President and Chief Executive Officer

Signature of Robert S. Harrison

Robert S. Harrison
Chair of the Board

Photo of Mark Mugiishi and Robert Harrison

2025 by the numbers

For nearly 90 years, HMSA has provided quality health plans for individuals, families, and employers. We’re making key changes to sustain high-quality and reliable care our members trust, ensuring access to care in Hawaii well into the future.

member

750,000+

HMSA members as of Dec. 31, 2025.

phone

92%

improvement in the average speed to answer commercial plan member calls.

In 2025, HMSA enhanced call center efficiency through strategic partnerships and continues to focus on improving processes to elevate members’ customer service experience.

giving

$1.1 million

in corporate giving.

$3.5 million

in HMSA Foundation giving.

In 2025, HMSA invested in various organizations and initiatives that advance community health and well-being.

cent

94 cents

of every dollar that HMSA collects in premiums goes directly to paying for our members’ care. The remainder covers administrative costs.

laptop

12,700+

average visits using HMSA’s Online Care® per month.

Online Care provides convenient telehealth access to non-emergency care from a laptop or other mobile device anywhere in Hawaii.

award

20 years

of the HMSA Kaimana Awards & Scholarship Program.

In 2025, the program honored 20 outstanding high school seniors from across the state who each received $5,000 scholarships and nine schools that received $1,500 awards.

stethoscope

10,500

physicians, specialists, and other health care providers in HMSA’s statewide commercial plan network.

hospital

20%

increase in walk-in visits to HMSA Center locations statewide for all HMSA members.

In addition, dedicated Medicare plan specialists at HMSA Centers in Honolulu, Kahului, and Pearl City are available to support members with their Medicare health plan needs.


Health care policy

Health care policy

policy

HMSA continues our work with state leaders, providers, and community partners to strengthen Hawaii’s health care system. By supporting the implementation of recently enacted policies and engaging with policymakers on legislation proposed during the 2025 legislative session, HMSA focused on expanding access to care and reinforcing workforce sustainability.

bill

2025 highlights included support for legislation related to:

  • Access to specialist care on Maui, which continues to face recovery challenges from the August 2023 wildfires.
  • Health care loan repayment programs, which help to attract and retain medical professionals in Hawaii.
  • Improving access, strengthening the health care workforce, and advancing equitable care statewide.

Providers

HMSA continued to strengthen our partnerships with providers across the state to support high-quality care and improve the health of Hawaii. Through efforts such as One Health Hawaii, we are working more closely with physicians, hospitals, and other care partners to improve coordination, expand access, and make care more affordable and sustainable for the people we serve.

In 2025, we strengthened our provider network and experience by:

  • Optimizing operations by refining our revenue cycle and claims process.
  • Enhancing care pathways, including increased outreach to independent providers.
  • Improving data, financial exchange, and governance procedures.
  • Expanding clinical collaboration with out-of-state specialists to improve member access to specialized care.
Providers-image
Employers

Employers

HMSA is focused on ensuring sustainable health plans for our employer groups. Our work with employers, local unions, and the Hawaii Employer-Union Health Benefits Trust Fund (EUTF) included customized well-being plans that improve employee health and emphasize preventive care. In addition:

  • HMSA’s commercial membership grew in 2025 as employers recognized the value of our health plans, local and away-from-home access to care, and premier member services.
  • In 2025, HMSA continued to receive high net promoter scores and customer satisfaction survey results from employers.
medicare advantage

Medicare and Medicaid

In addition to health plans for employer groups, families, and individuals, HMSA proudly offers Medicare Advantage and HMSA QUEST (Medicaid) plans. Highlights include:

policy

Dedicated Medicare health plan specialists continued to support current and prospective members during the Medicare annual enrollment period from October through early December.

bill

In 2025, Hawaii became the first state in the U.S. to offer community-based palliative care for Medicaid beneficiaries. For HMSA QUEST members, this benefit provides additional support for eligible members with serious illnesses, focusing on relieving symptoms to improve the quality of life for patients and their families.

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Medicaid member impact story

In 2025, HMSA supported a QUEST member who was diagnosed with cancer, had financial constraints and limited housing stability, and was experiencing emotional distress and hesitancy toward mental health support. Our health coordination team helped the member:

  • Improve health outcomes through consistent outreach.
  • Enroll in the supplemental nutrition assistance program (SNAP), which provides food and nutritional support to qualifying low-income individuals and households.
  • Schedule their first individual therapy session to receive mental health support.
  • Secure housing and connect with a community resource for furniture.

This story showcases our commitment to improving the quality of life for members by addressing medical, social, and emotional needs for lasting change.

Health management

care

HMSA’s health management model is designed to help members with the most complex health needs get the right support at the right time, while also partnering closely with the providers and care teams who serve them.

nurse

Our health management programs focus on members who may benefit the most from additional outreach. We connect with members during important moments, such as a hospital stay, an emergency room visit, or other significant health events, to offer timely support.

health-management
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Health management member impact story

Jerilette Cua, an HMSA transition care nurse, supported an HMSA Medicare Advantage member who was experiencing unexplained symptoms and needed more guidance and support with taking medications as prescribed.

Jerilette worked with the member’s provider to identify the correct medication the member should be taking, which improved the member’s health outcomes and health care experience.

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we-care
In 2025, HMSA progressed our We Care initiative for employees, designed to build a culture where employees want to work and contribute to our future health plan sustainability roadmap.
pay
By listening to employee feedback and offering meaningful benefits, HMSA made steady progress toward our We Care vision. Last year’s priorities included refining our performance management program and reviving employee and family events to strengthen connection and community. HMSA also expanded our focus on employee wellness by introducing a lifestyle spending account and a paid recharge day.

Community and workforce: Team HMSA

In 2025, we continued our commitment to Hawaii’s communities through volunteerism, partnerships, events, and investments that uplift health, education, and well-being across our islands.

donation

$162,500+

raised. HMSA and our employees and retirees donated to Aloha United Way (AUW) through a workplace giving campaign, supporting AUW in carrying out their critical work as an essential partner to the community, individuals and families, and local nonprofits.

volenteer

2,600+

volunteer hours. HMSA employees supported community activities, programs, and causes.

foodbank

200+

awareness walks, workplace development programs (externships), community service activities, and other community events statewide and in-kind support.

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The path forward: 2026 and beyond

Looking ahead, HMSA is committed to demonstrating market leadership and commitment to sustainability through forward-thinking collaborations with health system partners to improve care access, coordination, and efficiencies. We’ll continue to pay for care while proactively leveraging our unique role in the health care system to create new value that can be reinvested in community health.

Thank you for being a part of our journey.

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2025 Financial Report [PDF]