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.