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Hilo clinic to close, citing finances, few doctors

By Associated Press

LAST UPDATED: 10:43 a.m. HST, Feb 07, 2014

HILO >> A Hilo clinic offering medical care tailored to Native Hawaiians is shutting down after years of struggling with finances and a crippling doctor shortage.

Hui Malama Ola Na Oiwi plans to continue its community outreach, case management and transportation work. But its primary care clinic will close next month.

The Hawaii Tribune-Herald reports About 400 patients visit the clinic each month. Nearly 80 percent are covered by Medicare or Medicaid. Two percent are uninsured.

Traditional community health centers enjoy higher reimbursement rates from Medicare and Medicaid. But Executive Director Michelle Hiraishi says Hui Malama must cover its costs as if it were a private practice.

The clinic has relied on advanced practice registered nurses because of the doctor shortage. But that means many patients must be referred to others.

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cojef wrote:
Will the ACA in any way help keep this place open? Guess Medicaid payments to doctors are too low to make it worth while to practice medicine in Hilo. Wonder if the Government can force doctor to treat these patients? Thought doctor are sworn to treat the sick and injured.
on February 7,2014 | 10:28AM
kuewa wrote:
If you are asking whether doctors can be enslaved by the government, the answer is technically no since slavery is illegal. However, doctors and medical facilities which accept Federal funds for any reason are already indirectly enslaved with requirements to accept Medicare/Medicaid patients along with the low reimbursement rates that do not cover actual costs of maintaining the practice. In other words, by agreeing to set up a private practice in a M/C-only facility such as this Hilo clinic, the physician would not make enough money to cover staff, malpractice insurance, regulatory fees, electronic documentation costs, etc. Doctors are required to treat patients but only in the setting in which they choose to practice.
on February 7,2014 | 11:26AM
ellinaskyrt wrote:

Oh Lord. What kuewa fails to state is that physicians who eschew accepting federal funds are also avoiding higher quality of care standards. For example, a hospital that receives Medicare or Medicaid funds is inspected/audited on an annual basis to ensure that it is following not only federal laws, but health care standards (making sure that patient wounds are tended to in a timely/sterile manner, that a patient who is on moderate sedation is monitored properly and that the sedation is not used improperly for the ease of the staff as a restraint, that staff obtain two identifiers to confirm the correct patient is given the correct drug in the correct dosage at the correct time). A health care practitioner who accepts only private pay just isn't subject to audits the way those who accept Medicare/Medicaid are. If that's a form a slavery, then as a patient, I'm glad that the federal government is looking out for us to make sure that shyster health care providers are weeded out.

Look at Finley Boyle, the toddler who died after a visit to the dentist where her sedation was not monitored properly. Had Hawaii's dental industry been under regulation for that type of treatment, that little girl wouldn't have died. Better regulation - which comes with the acceptance of Medicare/Medicaid -- saves lives.

What would actually help is a single payor system, but we work with that which we have.

on February 7,2014 | 01:06PM
Carang_da_buggahz wrote:
i think you can also blame the ambulance-chasing lawyers for a huge part of this.
on February 7,2014 | 12:22PM
Beaglebagels wrote:
on February 7,2014 | 05:57PM
Bully wrote:
You cannot survive with medicare or medicaid patients.
on February 7,2014 | 01:43PM
Beaglebagels wrote:
on February 7,2014 | 05:57PM
HanabataDays wrote:
Single payor is the only way out of the mess the health insurance industry has created.
on February 7,2014 | 01:51PM
DiverDave wrote:
Now there is only 803 raced based Polynesian-Hawaiian only programs in this State!
on February 8,2014 | 08:25AM
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