Maui AgeWave’s ‘News Stand’ Page is a place for us to share our ideas and opinions! 

We will post our own views and ideas, as well as share cool information about the

growing industry of tele-care (with special emphasis on Hawaii.)

Our Opinion?  Let’s work together for a self-determined healthcare solution for Maui.

Legislatively Manadated Report on Condition of Hawaii Health Systems Services Corporation Now

Here are some notable quotes from the Stroudwater Report  regarding Hawaii Health Systems Corporation (HHSC) - 

the organization that manages Hawaii’s Public Healthcare System.    HHSC serves approximately one-fifth of the

total inpatient hospital volume in the State.

“HHSC is in a financially perilous condition. It received a “Going Concern” finding as part of its 2008 independent

audit report, calling the future financial viability of the organization into question. Its liquidity is at dangerously low

levels with barely enough current assets to meet current liabilities. It is far behind in its payments to vendors (80+

days). The age of its facilities and other physical assets are well above national averages. Its future viability is at risk,

particularly if the State is unable to provide increasing levels of operating subsidies for HHSC going forward. We

have assumed that the State will not have the capacity or tolerance to fund increasing subsidies going forward, and

seeks options that will allow it to substantially reduce HHSC subsidies as part of its overall imperative to balance the

State budget.”   (Page 7)

“We have estimated that HHSC should be re-capitalized using a State general obligation bond

falling into a range

between $256M ($56M of conversion; $200M recapitalization) and $456M

($56M cost of conversion and $400M

recapitalization.)”  (Page 8)

“Financially, Maui Memorial Medical Center has lost $75 million on operations over the past four fiscal years (2006-

2009 combined.” (page 52)

“HHSC’s current year subsidy of $111.64M represents approximately 10 percent of Hawai`i’s $1 billion

budget deficit.  What allows HHSC to continue operating are State subsidies from the General Fund,

augmented by special allocations to individual HHSC regions. Over 16% of HHSC’s operating budget

depends upon State subsidies (excluding Medicaid and disproportionate share payments.”  (page 12)

READ IT ALL!

                                              

 

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Makawao, HI - After reading the new 2010 version of “Medicine and You”, I must conclude that the answer is “no”. 

In a booklet of 126 pages there is but one paragraph on Telehealth.  Assuming the paragraph is one fourth of the

page, that makes the space allocated to telehealth about .19% of the book.  The content provided is even less

Here is how it works.  “Telehealth includes a limited number of medical or other health services like office visits

and consultations provided using an interactive two-way telecommunications system like real-time audio and video

“Telehealth is available in some rural areas, under certain condition, and only if the patient is located at one of the

following places: a doctor’s office (?), hospital, rural health clinic, federally funded-qualified health center, hospital-

based dialysis facility, skilled nursing facility, or community mental health center”. My first thought is, how many of

The other point that is missed by the policy statement is the omission of consideration being given to a person who

is aging in place (at home) or living at home with a disability.  The policy stated requires the individual to be

transported somewhere else to receive telecare. This, of course, defeats one of the main purposes of

telecare---to eliminate the transport.   I guess it would be like having to swim 10 miles to a pool for a swimming

Last, but not least, is the issue of the definition of rural.  The Medicare guideline uses the federal census definition

of Metropolitan area to determine rural areas.  For example, on the Island of Oahu there are no rural areas

because it has a population center of more than 50,000 and therefore the entire county (island) in which it exists is

a metropolitan area.  Contrast this with Maui County which does not have a city of 50,000 or more and hence the

The conclusion must be, If you want to use Medi---Care for Tele—Care, swim to Maui where you will be eligible if

Larry D. Carter, PHD

Partner, Maui AgeWave

Does Medi---Care about Tele---Care at Home?

This week's lead story is about a report that should be required reading for every agency. Judge me guilty

of hyperbole if you must but the Medicare cuts looming in the fallout from the healthcare reform debate

clearly indicate it is now time for our industry to be heard. This report provides you the bullhorn you have

been waiting for. Here is the executive summary but be sure to also read our lead article and download

is not "whether or not" but "how much." It needs to be turned so that "whether or not" is back on

reduce Medicare expenditures is to increase home care spending so that you can afford to invest

This is the strongest proof yet that it is time to stop looking at the cost of home health care -- including the

technologies that improve home care delivery -- as an island of activity that does not directly impact the

costs to government and private payers across all care centers. We have known that forever. No one has

yet adequately explained why our elected officials do not understand it as well as we do. Perhaps you

have not been telling them often enough. Perhaps you yourself have not been fully convinced.  Now you

have proof.

TM