(BIVN) – The troubling trends in Hawaiʻi island healthcare were presented to local lawmakers last week.
The Hawaiʻi County Council’s Human Services and Social Services Committee was given an Access to Healthcare on Hawaii Island presentation detailing the results of a recent survey, providing insights into the challenges the Big Island faces when it comes to connecting doctors and patients.
Lisa Rantz, the president of the Hawaiʻi State Rural Health Association and executive director of the Hilo Medical Center Foundation, joined Randy Kurohara, executive director of Community First, in presenting the findings to the council.
Rantz explained that the survey pulls together “all of the information that we hear anecdotally, as far as wait times, to be able to get in to see a provider. And then some providers saying that they are taking new patients, but in reality they’re taking cherry-picked patients. Patients with commercial insurance. They just simply can’t afford it, with the low reimbursement rates, to take Medicare and QUEST patients.”
Rantz said 30% percent of the Hawaiʻi island population is currently on Med-QUEST, which is “more than we’ve ever had before.” Providers are unable to keep up with the demand.
People are waiting four and six months to get in for cancer screenings and treatments. “Our folks are dying on the neighbor islands at a greater rate than they are on Oʻahu,” Rantz said, “and we die of things that they don’t die of on Oʻahu. And they certainly don’t die of on the mainland. And that’s just not what our community deserves.”
Rantz said the survey shows providers struggle with low reimbursement rates, and – for solo and small practice providers – the burden of the State’s general excise tax. “Based on the survey, community members are putting off care and it’s primarily our native Hawaiians our Asian Pacific Islanders, our Hawaiian Pacific Islanders,” she added.
Workforce shortages “came up as a huge indicator”. She said 76% percent of community members “said that they can’t get care because of lack of access to providers within the community, and their waiting times.”
“I just actually received an email yesterday from a woman in her early 60’s that waited 4 months to be able to get in to get a diagnostic treatment and she definitely has cancer,” Rantz said. “That’s heartbreaking.”
Rantz said the survey also took a look at telehealth services. “We just had a primary care provider leave our state in the end of December,” she said. “She was providing more care via telehealth to mainland patients to support her primary care habit. There’s radiologists in North Hawaiʻi that are only seeing and reading scans from the mainland, because they get better reimbursement rates. They’re not seeing patients in Hawaiʻi. So, when we look at the list of folks that carry licenses within the state, when we scrub that list down to those that are actually taking care of patients, our shortages are much larger than what they appear to be.”
“What we found in our survey is the elite, white citizens that have good broadband can access telehealth,” Rantz said, “but those that live in more rural remote areas do not have the access to it.”
The survey also examined mental health. “Obviously, we’ve always had some mental health shortages as far as providers,” Rantz noted, “but during COVID we’re seeing that exacerbated, even in our younger populations, down to elementary, are really struggling.”
Rantz pointed to one slide in her presentation that she said was “frightening”, showing that among providers, “49% of those surveyed are considering reducing hours, 47% are considering leaving medicine all together, and 44% percent are preparing to move to the mainland.”
“The vision again was to ensure that everyone on Hawaiʻi island has access to quality healthcare, timely healthcare, close to home,” said Randy Kurohara. “What that would require is all of our provider groups kind of working together and the great thing is that during COVID we saw that. We saw a lot of people that normally don’t work together, actually come together to share information about what each one is doing.”
The Access to Care website can be found online for more information.