LIHUE — A change in Hawaii’s care delivery system is in the works and it’s a fundamental departure from the current fee-for-service model, which reimburses doctors based on visit numbers and service types.
The anticipated result, according to Mike Gold, president of Hawaii Medical Service Association, is a new system that will allow doctors to take more time and develop stronger relationships with patients.
“We’re going through a payment transformation that’s not happening anywhere else,” Gold said. “It’s radically different than what’s happening anywhere else.”
The new system is set up to reimburse physicians at a fixed monthly rate for each patient, whether the patient schedules a visit.
Gold said the payment transformation is expected to roll out in January 2018 and is being tested in pilot programs on Oahu and on Maui. The roughly 100 physicians involved “will never go back (to the fee-for-service model) again,” he said.
While some have voiced concerns that the new system will encourage physicians to see as few patients as possible, Gold said the 100,000 HMSA members involved in the pilot programs are providing positive feedback.
“We want to change the care delivery system in this state so physicians have more time to work with you and to get you to an optimal state of health,” Gold said.
Gold was one of the keynote speakers at Tuesday’s Chamber of Commerce luncheon, hosted by Wilcox Health and Hawaii Pacific Health at the Kauai Beach Resort, with the theme of creating a healthier Hawaii.
Access to care, connecting health professionals with the community, and spreading education were the main points of conversation.
“In terms of creating a healthier Hawaii, (our focus is on) prevention and access to care,” said the luncheon’s other keynote speaker, Geri Young, chief medical officer at Kauai Medical Clinic, “so patients on Kauai don’t need to go to Oahu.”
She said creating a healthier Hawaii also means getting resources and education to the community, which has been done through a laundry list of events on Kauai.
Those include Wilcox Health’s Walk Around the Block with a Doc, Live Healthy Kauai, the A Healthier You Program, the Kids’ Summer Fest, and booths the Kauai Marathon.
Young said Wilcox Health is focusing on spreading education to youth. For example, Wilcox has partnered with the middle and elementary schools in the Department of Education, as well as with Island School, to increase stroke awareness amongst children.
They’ve developed a magnet that lists the warning signs for a stroke that keiki can take home.
“The thought was to have our children who grow up with grandparents to be aware of strokes,” Young said. “This year we’re working with the high school.”
Though health professionals on the island are talking about increasing the health and vibrancy of the community, Gold said Kauai is doing well.
“The level of care on Kauai is better than any of the other neighbor islands,” Gold said. “It’s because of the leadership of the community that the health of this island is as good as it can be in Hawaii.”
Gold said he witnesses a higher level of activity and a larger amount of the population keyed into health issues on Kauai than on other islands.
“It’s uplifting to walk around and hear people talking about health and fitness,” Gold said.
One of the things contributing to a healthier Kauai, according to Gold and Young, is the network of walking and biking paths being created around the island.
“We’re all about paying your claim, but our mission is about increasing the health of everybody in the state,” Gold said. “We are trying to touch every part of influence in the state and we will support that (goal) in every way.”
Questions from the audience regarded the spread of the Zika virus and the recent cluster of Hepatitis A cases diagnosed on Oahu wrapped up the luncheon.
Young said Wilcox Health is working with Hawaii’s DOH to address illnesses transmitted by mosquitoes, and that the most recent case of Zika virus diagnosed on Kauai holds no threat to those on the island.
“There’s no way you can get Zika on our island right now,” Young said.
Both Young and Gold said getting a Hepatitis A vaccine is something that should be discussed and carefully considered with each individual’s primary care physician.
“At this point it’s an individual’s call, there’s no Hep. A on Kauai that’s related to Oahu,” Young said.