Emergency Department Care Pathways Program

The Emergency Department (ED) Care Pathways Program is here to support members who visit the ED often or may be at risk for repeated visits. Our goal is to help you stay healthy, feel supported, and get the care you need without unnecessary trips to the ED.

We work with you to understand what’s causing your ED visits and connect you to the right care options, services, and resources. This program is voluntary and available at no cost to eligible HMSA members.

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How the Program Helps You

If you’re enrolled in the ED Care Pathways Program, you’ll receive personalized support to help you:

  • Get connected to a primary care provider or medical home.
  • Access behavioral health support when needed.
  • Find and use community resources that support your health and daily needs.
  • Learn when and where to seek care outside of the ED.
  • Feel more confident managing your health.

Our approach focuses on prevention, education, and ongoing support and not just treating urgent issues as they arise.

A Team that Works with You

You’ll be supported by a dedicated care team that may include:

  • Registered nurse (RN) who help coordinate your care and answer health questions.
  • Community health worker (CHW) who assist with navigating community resources and services.
  • Behavioral health specialist (BHS) who provide additional support for emotional or mental health needs when appropriate.

Your care team works together to create a plan that fits your needs, preferences, and goals.

What to Expect

Members in the program may receive:

  • Outreach by phone, in-person visits, or other communication methods.
  • One-on-one education and coaching.
  • Help scheduling appointments and follow up care.
  • Guidance about alternatives to the ED for non-emergency needs.

Everything we do is focused on helping you get ongoing, appropriate care and improving your overall health experience. For more information, call HMSA Health and Well-being Support at 1-855-329-5461, option 1.

Additional Resources

Here are links to instructions and forms that you may need.

HMSA Coordination of Benefits

This form will help coordinate your health plan benefits.

Advance Health Care Directive

An Advance Directive is a written statement about your future medical care.

HMSA Authorized Representative form [PDF]

Complete this form to appoint a family member, friend, or another person who may need to access your health information on your behalf.

Mail-service Order form

Mail-order prescription medications are available to most HMSA drug plan members. You can save money with mail-order drugs because copayments are generally lower than when you buy from retail pharmacies. Check your drug plan certificate to see if you have mail order as a benefit.

External Resources for Additional Support:

Elderly Affairs

808-643-2372

City and County of Honolulu Elderly Affairs Division

elderlyaffairs.com/

808-768-7700

CMS Coordination of Benefits

Click on the CMS.gov link. If you have more than one health plan, coordination of benefits will ensure that the primary plan pays first.

Maui County Office on Aging

mauicountyadrc.org/

ADRC Statewide: 808-643-2372

Maui: 808-270-7774

Molokai: 808-553-5241

Lanai: 808-565-6818

Hawaii County Office of Aging

hcoahawaii.org/

808-961-8600

ADRC Statewide: 808-643-2372

Hilo: 808-961-8626

Kona: 808-323-4392

County of Kauai Agency on Elderly Affairs

kauaiadrc.org

808-241-4470

Hawaii CARES Crisis Hotline – Call 988

https://hicares.hawaii.gov/

Crisis hotline 988

More Resources to Help You on Your Journey.

after-hours care

A Guide to After-hours Care [PDF]

Use this guide so you know where to go for your care.

icon benefits

Your Guide to Benefits tells you what your health plan pays for and what you can expect to pay out of pocket. You may access your Guide to Benefits through My Account. If your plan’s Guide to Benefits isn’t online, call us at 808-948-6079 or 1-800-776-4672.

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Health Condition Support and Resources

Get personalized support for your health conditions. Our team of clinicians, coaches, and educators can help connect you with the resources you need.

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Health Education Workshops

Attend workshops in person or online at no cost on a variety of well-being topics, such as nutrition, physical activity and exercise, stress management, and more.

Disclaimer

The information you obtain from the sources on this site or any other service offered by or through this site should not substitute for or be used instead of a relationship with a health care professional. We encourage you to seek the advice of and regularly consult with doctors and other health care providers of your choice.