Doctors on the Big Island can’t afford to take patients who have Medicare and Medicaid due to low reimbursement rates.
“There’s a struggle with low reimbursement rates, there’s taxes on small service provides, so community members are putting off care,” Lisa Rantz, president of the Hawaii State Rural Health Association, told a Hawaii County Council Committee on Tuesday.
To better understand the community’s health needs, Community First Hawaii put out a survey last fall seeking input from health care providers and community members. Community First is a nonprofit founded by the late Barry Taniguchi of KTA Super Stores.
What the Access to Care survey found was that due to a lack of financial reimbursement and expensive living conditions in Hawaii, that almost half of the physicians on the Big Island were considering reducing hours, leaving the medical field altogether or moving off the island.
“I originally planned to retire in 2012, but have been unable to find anyone to refer my patients to,” said one physician in the study.
More, only 21% of patients in the study said they could see a doctor whenever they wanted and a lack of physicians was the biggest barrier to accessing health care. Most affected were cancer patients, or those in dire need of services.
“Cancer patients are waiting months to see a doctor,” Rantz said. “So how are patients impacted? They’re sicker than ever.”
In addition to low reimbursement rates, doctors also mentioned high cost of living as one reason they were fleeing the island.
“Working in Hawaii is challenging because of the significant pay cuts in comparison to the continent/ rural communities and the high cost of living,” said one physician in the survey. “The biggest challenges have been a lack of infrastructural support for providers. I have never felt so hopeless as when I worked in Hawaii.”
According to South Kona Council Chairwoman Maile David, the results of the study were heartbreaking.
“I can imagine it’s really hard for people who don’t have the right insurance,” she said. “I can imagine how difficult that might be. I thank you for bringing that awareness to the public. The details are frightening.”
The survey included a total of 2,248 interviews with 225 health care providers and 2,023 community members.
Data showed that 59% of physicians believed their community was unhealthy, and 45% of residents felt the same.
During the hearing, Randy Kurohara, executive director of Community First Hawaii, asked the council to take action.
“Our whole goal is to identify actionable items that everyone can have a piece in the puzzle to make this a better place,” he said.
He also noted that transportation is one area that can be improved to aid community members in getting to their appointments.
“Transportation sounds like something you folks do, and that’s a big piece,” he said.
Community First Hawaii announced April 1 it was launching the Access to Care healthcare campaign and statewide survey open to all Hawaii residents throughout April.
The effort aims to get a better understanding of the health care gaps in communities to improve on and achieve healthier outcomes in Hawaii. The statewide campaign will work with half a dozen healthcare, government, and social services partners, while collecting information from the public about their experiences in accessing the care they need.
Residents can access the survey at https://www.surveymonkey.com/r/6XN8LCV.