Health execs back measure that benefits Hawaii’s most vulnerable

Hawaii health officials are pushing a bill that could give community health centers nearly $20 million to help thousands of Medicaid patients with chronic conditions improve their health.

House Bill 1161 proposes to take advantage of a 9-to-1 match program for federal money available through the Affordable Care Act, also known as Obamacare.

The bill would give health centers the state backing needed to apply for the federal money. The funds would be used to target patients with multiple complex diseases under Medicaid, the government health insurance program for low-income residents.

Community health centers have pledged to invest $2 million to draw down $18 million in federal dollars to expand so-called Medicaid health homes in which providers coordinate all primary, acute, behavioral health and long-term care services for patients in low-income communities across the islands.

The state would need to invest at least $1 million for administrative costs. The measure is now in the Senate Ways and Means Committee but has yet to receive a hearing.

"At little cost to the budget, this bill provides an opportunity to bring health care resources to areas of our state with extremely high need," said Dr. Robert Hirokawa, chief executive officer of the Hawaii Primary Care Association, representing the state’s 14 federally qualified health centers. "We feel the health home model of care has a long-term potential to save millions of dollars in Medicaid."

Community health centers serve one-fourth of the state’s Medicaid population, including the uninsured and underinsured, many of whom have multiple chronic conditions such as diabetes, heart disease and mental health problems.

The health centers are seeking to establish statewide the team-based model to provide integrated services to not only improve health outcomes, but reduce hospital admissions and expensive emergency room visits that on average cost about $1,300.

Across the nation, the team approach has been proven to improve health, lower medical costs and increase patient satisfaction, health centers say.

By reducing long-term Medicaid costs, the model also has the potential to alleviate some of the state’s budget problems, Hirokawa added.

"Improving the health of these patients is critical," he said. "Just as critical is reducing health care costs for the entire state, which has been one of our goals for years. That’s why health centers are willing to invest their own resources to help make this happen."

Richard Bettini, president and CEO of the Waianae Coast Comprehensive Health Center, said the money is crucial to improve the health of the state’s most vulnerable low-income population and keep programs operating.

"Attracting $18 million in new funds into Hawaii’s lowest-income communities will have multiple benefits," Bettini said. "In addition to providing more resources at the community level to address complex medical conditions, this initiative will save jobs in our community and create new opportunities to address preventable costs in health care. Without these funds, we will see cuts in preventive and community services by midyear 2015."