Regulatory The crippling effect of low Medicare-Medicaid reimbursements and regulatory restrictions on Hawaii health-care providers and patients is expected to dominate meetings here with a top official of the program.
burden angers
local doctors
Health-care providers
Rheumatologist shortage worsens
plan to air frustrations
at meetings this weekBy Helen Altonn
haltonn@starbulletin.com"We're losing doctors, and doctors are taking fewer Medicare patients," said Dr. Philip Hellreich, Hawaii Medical Association legislative chairman and immediate HMA past president.
Thomas Barker, senior outreach and policy adviser to Thomas Scully, administrator of the Centers for Medicare & Medicaid Services of the U.S. Department of Health and Human Services, will hold an "open door forum" for island health care providers at 6 p.m. tomorrow. The Hawaii Medical Association and all county medical societies are sponsoring the event at the HMA conference room, 1360 S. Beretania St.
The Centers for Medicare & Medicaid Services began the forums in June 2001 to hear what it's like to work under Medicare-Medicaid rules and get suggestions for improvement from seniors, patients, physicians, hospitals, clinics, health and state workers, nurses and others involved with health care.
Rich Meiers, president and chief executive officer of the Healthcare Association of Hawaii, said nearly 60 Hawaii acute, long-term, home care and hospice providers will meet with Barker on Tuesday at St. Francis Medical Center.
He said that because so many providers signed up for the meeting, it shows the seriousness of the problems, ranging from inadequate reimbursements and regulatory requirements to a $50 million increase in federal Medicaid matching funds to the state the past year that didn't reach providers.
Federal reimbursements for hospitals and physicians "do not meet costs, let alone any profits," Hellreich said. "It's a tough business to keep providing services when they are not being reimbursed."
Hawaii's health care providers also are hit by living costs 37 percent higher than those on the mainland, and reimbursements don't make up that difference, Hellreich pointed out. "They're lumping us with other states (in setting Medicare/Medicaid rates)."
Hellreich, a dermatologist, said he's having problems referring sick patients to rheumatologists because there are only about a dozen in the state and two are leaving.
Some orthopedic surgeons also are leaving town, he said.
"I don't think elected officials or the public at large are aware we're on the verge of losing a whole bunch of physicians who just can't make it here."