Facilities estimated to save hospitals $80M
More care-home beds would allow patients to leave hospitals sooner, a panel finds
Hawaii hospitals could save roughly $80 million to $90 million a year if facilities were available for long-term care patients ready for discharge, said House Health Chairman Joshua Green.
"All of a sudden, our hospital system might find itself feeling healthy," said the Big Island doctor (D, North Kona-Keauhou-Kailua-Kona-Honokohau).
Green estimated that the hospitals could reduce their $150 million in annual losses by 53 percent to 60 percent if enough nursing-home beds became available.
The problem is unique to Hawaii because long-term care patients have to wait for transfers to nursing homes and other facilities, a Healthcare Association of Hawaii Waitlist Task Force reported to the House Health Committee.
The number of "medically and behaviorally complex patients" on the waiting list has grown from about 180 in 2005 to as many as 275, the task force said.
Medicaid payments cover only 20 percent to 30 percent of the costs for wait-listed patients at hospitals, and waits could continue more than a year, it said.
The task force is recommending action to increase long-term bed capacity and services, remove regulatory and government barriers, and address work-force shortages.
"We will seek legislative support for fair payment to providers to stop the hemorrhaging," Coral Andrews, HAH vice president and task force chairwoman, told Green and Health Vice Chairman John Mizuno (D, Kalihi).
Green proposes creating health enterprise zones similar to business enterprise zones as part of a Rural Health Act addressing a shortage of physicians and other critical Hawaii health-care problems.
"I am very keen on getting those long-term beds built with this Rural Health Act and (providing) resources to train more nurses and nurse's aides and continue to bring in doctors," he said.
He envisions providing state land and significant tax incentives to attract investors to develop long-term care facilities throughout the state.
The Hawaii Health Systems Corp., which operates 12 state hospitals, mostly in rural areas, has asked the governor for a $25.4 million emergency appropriation because of soaring costs, partially because of wait-listed patients, said spokesman Miles Takaaze.
Hawaii ranks 48th in the nation with its low ratio of long-term care beds per population, averaging 23 beds per 1,000 people, compared with the national average of 47, the task force reported.
An increase of 2,392 long-term care beds -- 53 percent -- would be needed by 2020 just to maintain the present inadequate bed ratio, the report said.
Mizuno said he has "a very big concern" about transferring seniors from Hawaii hospitals to mainland long-term care facilities, which has been done in some cases. "We want to keep them here."
Andrews agreed but said some providers will not take a patient who is "behaviorally complex," adding, "It is a true dilemma."
She said local and mainland providers are interested in meeting Hawaii's long-term care needs but say land and startup costs are big obstacles.
"If we can fix the long-term care waiting list situation for the state, it is a real win-win for everybody," said Dr. Virginia Pressler, Hawaii Pacific Health executive vice president for strategic business development and Waitlist Task Force member.
"We would be addressing the single most important thing that's bankrupting the health system right now."
