Hawaii Residents Increasingly Seeking Care At Strained Community Health Centers

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The Honolulu Star-Bulletin this week published a two-part series examining access to care at community health centers in Hawaii. Summaries of the articles appear below:

Demand: Hawaii residents increasingly are seeking treatment at community health centers as more physicians leave the area or stop accepting Medicare and Medicaid beneficiaries, the Star-Bulletin reports. The 13 health centers in the state collectively see 100,000 patients annually at one of 50 sites on five islands. Last year, the centers treated 29,562 of the state's 120,000 uninsured residents and 39,288 of the state's 200,000 residents with state-sponsored MedQUEST coverage. An additional 7,181 Medicare beneficiaries and 22,404 patients with private insurance were treated at the centers last year.

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However, Hawaii Primary Care Association Executive Director Beth Giesting said, "We're not reaching the population in need, on the neighbor islands particularly." The facilities provide "culturally appropriate services," and all of the centers serve "federally designated underserved areas and populations that do not have access to health care for economic, cultural or geographic reasons," the Star-Bulletin reports. While the demand for more centers exists, officials say finding the money and land to build new facilities is a major hurdle, forcing existing facilities to be stretched to their limits (Altonn, Honolulu Star-Bulletin, 9/3).

Insured patients: Insured patients who cannot find physicians on the Big Island increasingly are seeking care at community health centers, which can reduce federal Medicare and Medicaid reimbursements to the facilities, according to Hamakua Health Center Medical Director Brian Williams, the Star-Bulletin reports. Williams said that although they accept all patients, "the more insured patients we have, the lower our reimbursements for our target population."

Federal funding to the centers is based on the percentage of Medicare and Medicaid beneficiaries treated. Richard Taafe, executive director of West Hawaii Community Health Center, said in the Kona area, five doctors have closed private practices in the past six to seven months and more are closing. Taafe said, "We've seen an increase in private pay patients coming in because they no longer had a provider." Williams said, "We actively advocate for the changes necessary so doctors can come into private practice here. We need competition so we can take care of patients who really need our services" (Altonn, Honolulu Star-Bulletin, 9/4).

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