5 Things HI: Scott Miscovich, BCRA, hospital charity care

I hear there is an interesting slate of summer movies out, but the latest episode of “Game of Thrones” has much of my attention.  And, by “Game of Thrones,” I mean the debacle happening on health policy in Washington DC as the Senate ties itself in knots.

It’s some of what we’re watching in Hawaii health care for July.

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1.  Congressional delegation in reform debate

As debate over federal health care reform continues, Hawaii’s Congressional delegation has introduced legislation to restore Medicaid coverage to Freely Associated States citizens living in the US. Expanding coverage would decrease uncompensated care costs in Hawaii.

And while Senators Hirono and Schatz haven’t released official statements on the Senate’s Better Care Reconciliation Act, they have both been actively critical on Twitter. Hirono spoke out the day before she had surgery for cancer treatment (she’s recovering well) and Schatz criticized Ted Cruz’s amendment. Today, the CBO announced it expected 32m would lose coverage under the Senate bill. Read the CBO report here.

Speaking of Sen. Schatz, he will be honored tonight at the Tin Cup Awards Dinner in Washington DC at the Canadian Embassy. The event host, the Washington Government Relations Group, is the association of African American lobbyists in town, and will be feting Sen. Schatz for his progressive work for people of color.


2.  Q&A with Dr. Gerard Livaudais, HPH

We recently interviewed Dr. Gerard Livaudais, vice president at Hawaii Pacific Health. Dr. Livaudais is responsible for the HPH’s accountable care organization, Hawai’i Health Partners. He talked to to us about HPH’s recent partnership with HMSA to create a new model of care that emphasizes clinical integration and care coordination.

“We have set aside our historical positions and started anew with fresh relationships. We have at least five joint working groups with HMSA on everything from analytics to back office operations, medical management and marketing and community affairs. This is not just the executive level, this is the people who do the work getting together, talking to each other and often meeting for the first time. It’s building a different level of trust and cooperation that I think will prove very important in going forward with this relationship.”


3.  Federal reform and Hawaii’s hospitals

The Commonwealth Fund released a study on how the AHCA’s changes to Medicaid would impact hospitals. The study was released ahead of the Senate’s Better Care Reconciliation Act discussion draft, which has similar changes to Medicaid. As an expansion state, Hawaii would be hit hard.

Hawaii’s acute care hospitals are projected to see a 94 percent increase in uncompensated care costs over the next decade. Rural hospitals would see an 84 percent increase. Projected operating revenues are projected to decrease to -13.2 percent for acute care hospitals and -19.7 percent for rural hospitals by 2026.


4. Video:  Scott Miscovich, MD

Dr. Scott Miscovich is the owner of Windward Urgent Care and Primary Care Physicians. He has also served as Chairman of the State of Hawaii Narcotics Policy Work Group for the last four years.

He joins us in this edition of “What They’re Watching” to talk about Hawaii’s homelessness problem and it’s connection to addiction and behavioral health.  The CDC’s recent report on the opioid epidemic reveals that while the number of prescriptions are dropping, the average length of prescriptions are increasing, which increases the risk of addiction.


5.  A few quick things

To bring you up to speed on some changes at various Hawaii providers, I’ll leave you with a brief summary of recent coverage at State of Reform.

Three community health centers received federal grants over $4 million: Waianae Coast Comprehensive Health Center ($1.7m), the Community Clinic of Maui ($1.3m), and the Bay Clinic ($1m).  Kaiser Permanente’s affiliate Maui Health System has assumed management of three community hospitals: Maui Memorial Medical Center, Kula Hospital and Lanai Community Hospital.  The Queen’s Health System has named Angela Macera Director, System Behavioral Health and launched a telemedicine ICU at North Hawai’i Community Hospital.