Why a critical-access hospital in West Maui will be success

Writers on this page have wondered how a new hospital could succeed in West Maui when so many hospitals in the state system are losing money. They have also asked where the doctors will come from, considering it is so expensive to live here.

The good news is that the proposed West Maui

Hospital and Medical Center will be different from every hospital in the state of Hawaii. It will be designed and built solely as a 25-bed critical-access hospital.

The Center for Medicare and Medicaid Services defines a critical-access hospital as a rural, acute-care facility providing emergency services with a maximum of 25 beds. In a rural area with unique geography such as ours, a critical access hospital must be more than 15 miles from the nearest hospital. Our new hospital will be more than 21 miles from the only full-service hospital on Maui.

The center will reimburse West Maui's critical-access hospital 101 percent of its costs for Medicare and Medicaid patients. Since larger acute-care hospitals are paid by Medicare/Medicare, based on a pre-established per patient discharge rate that is often far less than the hospitals' actual costs, critical-access hospitals have distinct economic advantage. It is this advantage that will make our hospital financially viable.

CAHs are common throughout rural areas of the Midwest not unlike our own except that we are an island. Although at least eight state-run hospitals in Hawaii have some critical-access beds, none have been designed and built to be critical-access hospitals.

Our new community hospital will rarely have so-called wait-listed patients kept in acute beds because there is nowhere else for them to go. Our patients will either move to our adjoining 40-bed skilled nursing facility or to another health care facility where they will get more specialized or critical care treatment. Our skilled nursing facility will also provide a significant financial benefit to Maui Memorial Medical Center by admitting some of its wait-listed patients.

As for recruiting doctors, our privately owned West Maui Hospital and Medical Center will work on a different model than public hospitals. To the extent allowed under Medicare/Medicaid regulations, our hospital operator, Southwest Health Group LLC, will offer its doctors the opportunity to become investment partners in our private hospital, skilled nursing facility and the future assisted living facility and medical services building. By making it possible for doctors to invest, we will be offering them an economic incentive that has been largely unavailable to attract physicians.

We will bring in highly competent local and Mainland doctors in their 40s, 50s and 60s who have had well-established practices and the means to live on Maui. We also think they might just like the idea of living in paradise.

Our dream for Maui is to start with a critical-access hospital and skilled nursing facility. Both require a certificate of need from the state. Simultaneously with start of construction we will also build a 40-unit assisted living facility and a medical services building, neither of which requires state approval.

The West Maui Hospital and Medical Center will also provide tens of millions of dollars in annual economic benefit directly to the entire island community, not to mention the immediate access to high quality acute care and long-term-care services to the residents and visitors.

In these times when tourism appears to be slowing, what better time for an economic infusion by creating a successful hospital. Residents and visitors will get more immediate emergency care. Construction jobs will be created. New facilities will provide more employment opportunities. With a new critical-access hospital, everybody wins.

Brian Hoyle is president of Newport Hospital Corp., the developer of the West Maui Hospital and Medical Center.