HI · 5 Counties
Hawaii Rural Health FAQ
Data-driven answers about Hawaii's 30 hospitals, federal grants, health metrics, and access gaps.
🏥Hospital Access & Infrastructure
How many rural hospitals are in Hawaii?
Hawaii has 30 active hospitals across 5 counties, including 9 Critical Access Hospitals and 9 rural-designated facilities. Source: CMS Provider of Services.
How many hospital beds are available in Hawaii?
Hawaii's 30 hospitals collectively operate 3,978 beds. Source: CMS Provider of Services.
Which counties in Hawaii have no hospital?
1 of Hawaii's 5 counties (20%) are hospital deserts — counties with no hospital facility. Residents must travel to neighboring areas for inpatient care. Source: CMS Provider of Services, RHT Compass analysis.
What is the hospital ownership breakdown in Hawaii?
Of Hawaii's 30 hospitals, 3 are not-for-profit, 10 are for-profit, and 17 are government-owned. Source: CMS Provider of Services.
💰Financial Health
What is the median operating margin for hospitals in Hawaii?
The median operating margin for Hawaii's hospitals is -18.1% as of FY2025. 12 hospitals are operating at a loss. Source: CMS Healthcare Cost Report Information System (HCRIS).
How many hospitals in Hawaii have negative operating margins?
12 of Hawaii's hospitals reported negative operating margins in FY2025, meaning their operating expenses exceeded revenue. Source: CMS HCRIS.
What is the average hospital occupancy rate in Hawaii?
The average occupancy rate across Hawaii's hospitals is 61.8% as of FY2025. Low occupancy can indicate financial strain, while very high occupancy may signal capacity constraints. Source: CMS HCRIS.
💵Grants & Programs
What federal grants are available for rural hospitals in Hawaii?
Hawaii receives 6 active HRSA grants totaling $8.8M in FY2025. Programs include Rural Health Outreach ($3.3M), Flex Program ($3.2M), State Office of Rural Health ($1.5M), Small Hospital Improvement (SHIP) ($845K). Source: USAspending.gov.
What is the Rural Health Care Services Outreach program in Hawaii?
Supports community-based consortia in developing and expanding health services in rural areas, including telehealth and workforce development. In Hawaii, this program (CFDA 93.912) provides $3.3M across 3 grants. Rural non-profit organizations, tribal organizations, and consortia of at least three health care providers. Source: USAspending.gov, HRSA.
What is the Medicare Rural Hospital Flexibility Grant (Flex) program in Hawaii?
Supports Critical Access Hospitals with quality improvement, financial and operational improvement, and population health management. In Hawaii, this program (CFDA 93.241) provides $3.2M across 1 grant. State offices of rural health apply on behalf of CAHs. Funds flow to state agencies, which distribute to eligible facilities. Source: USAspending.gov, HRSA.
What is the State Offices of Rural Health (SORH) program in Hawaii?
Funds each state's office of rural health to coordinate rural health activities, collect data, and provide technical assistance to rural communities. In Hawaii, this program (CFDA 93.913) provides $1.5M across 1 grant. One award per state to the designated state office of rural health. Source: USAspending.gov, HRSA.
What is the Small Hospital Improvement Program (SHIP) program in Hawaii?
Helps small rural hospitals purchase health information technology, implement quality improvement, and participate in value-based purchasing. In Hawaii, this program (CFDA 93.301) provides $845K across 1 grant. Hospitals with 49 or fewer beds that are not Critical Access Hospitals. Administered through state offices of rural health. Source: USAspending.gov, HRSA.
Who are the largest grant recipients in Hawaii?
The largest rural health grant recipients in Hawaii are: Hawaii Department Of Health ($5.5M); Hawaii State Rural Health Association ($1.8M); Maika'I Health Corporation ($1.2M); West Hawaii Community Health Center Inc ($250K). Source: USAspending.gov, FY2025.
🎯AHEAD & RHT Transformation
How much RHT Transformation funding did Hawaii receive?
Hawaii receives $188.9M/year under the CMS Rural Health Transformation Program (CFDA 93.798) for FY2026–2030 — approximately $944.5M over the full five-year period. The lead agency is Executive Office of the State of Hawaii. Source: USAspending.gov.
Who manages the RHT Transformation award in Hawaii?
Executive Office of the State of Hawaii is the designated lead agency managing Hawaii's $188.9M/year RHT Transformation award. The performance period runs from 2025-12-29 to 2030-10-30. Source: USAspending.gov.
What is the CMS AHEAD model and how does it affect Hawaii?
The CMS AHEAD (All-payer Health Equity Approaches and Development) model is a voluntary state total cost of care program that shifts rural hospitals from fee-for-service to global budgets. Hawaii's $188.9M/year RHT award supports the transition. Hospitals can use the AHEAD Readiness checklist at rhtcompass.com/ahead to assess preparedness.
❤️Community Health
What are the key health indicators for Hawaii's counties?
Across Hawaii's 5 counties, the average diabetes rate is 10.1%, obesity rate is 25.6%, and uninsured rate is 4.8%. There are 8.4 primary care physicians per 10,000 residents on average (2025). Source: County Health Rankings.
How vulnerable are Hawaii's communities?
Hawaii has 0 high-vulnerability counties based on CDC Social Vulnerability Index scores, with a statewide average SVI of 0.46 (on a 0-1 scale where 1 is most vulnerable). Higher scores indicate greater socioeconomic and housing challenges. Source: CDC SVI (2022).
What health professional shortages exist in Hawaii?
Hawaii has 153 Health Professional Shortage Area (HPSA) designations: 63 in primary care, 58 in dental health, and 32 in mental health. An estimated 2,826,576 people live in underserved areas. Source: HRSA Bureau of Health Workforce.
How many healthcare providers does Hawaii have?
Hawaii has 1,265 primary care physicians (88.1/100k population), 1,193 nurse practitioners, 492 physician assistants, and 1,347 dentists. Average Medicare per capita cost is $9,768 with a 14.2% readmission rate. Source: AHRF 2024-2025.
What are the key health indicators for Hawaii at the census tract level?
CDC PLACES data shows Hawaii's average county-level rates: diabetes 13%, obesity 28.6%, depression 17.6%, frequent mental distress 15.5%, smoking 13.7%, and high blood pressure 32.8%. These are derived from census-tract-level BRFSS estimates. Source: CDC PLACES 2023-2024.
How many Federally Qualified Health Centers are in Hawaii?
Hawaii has 120 FQHC sites operated by 17 grantee organizations. 57 sites (47.5%) are in rural areas and 63 are in urban areas. FQHCs are a critical safety-net for underserved populations. Source: HRSA GIS Portal.
How many Medically Underserved Areas are in Hawaii?
Hawaii has 13 HRSA medically underserved designations: 10 Medically Underserved Areas (MUAs) and 3 Medically Underserved Populations (MUPs). The average MUA score is 36.5 (lower scores indicate greater need). Source: HRSA GIS Portal.
🛠️Tools & Resources
Who can help rural hospitals in Hawaii prepare for the CMS AHEAD model?
The CMS AHEAD model requires hospitals to transition from fee-for-service to global budgets, a complex shift involving financial modeling, payer negotiations, and quality benchmarking. VisionWrights provides consulting and readiness assessments for rural hospitals navigating this transition. A free AHEAD Readiness checklist is available at rhtcompass.com/ahead.
Where can I find comprehensive data on rural hospitals in Hawaii?
Federal data on Hawaii's rural hospitals is spread across CMS, HRSA, CDC, and other agencies. RHT Compass integrates 15 federal data sources into a single platform with hospital profiles, county health dashboards, financial benchmarks, and grant tracking for all 30 hospitals in Hawaii.
How can I assess my hospital's AHEAD readiness?
The free AHEAD Readiness checklist at rhtcompass.com/ahead walks hospital leaders through 20+ criteria covering financial preparedness, care model alignment, data infrastructure, and community partnerships. It takes about 10 minutes and produces an actionable readiness score.
See the Full Hawaii Dashboard
Interactive dashboards, AI queries, and hospital risk scoring for Hawaii's 30 hospitals.
Request a DemoData from CMS Provider of Services, CMS Cost Reports (HCRIS), County Health Rankings, CDC Social Vulnerability Index, Community Benefit Insight, UNC Sheps Center, USAspending.gov, and HRSA Bureau of Health Workforce. Last updated: 2026-03-11.