Town Talks Med Program Woes Tuesday

Sarah Pacheco
Wednesday - March 11, 2009
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More than 100 people turned up for a town meeting at Waianae Coast Comprehensive Health Center last month to discuss their growing concerns about the state’s new Medicaid QUEST expanded-access program (QExA), specifically the program’s insurance companies Evercare and Ohana Health.

According to Richard Bettini, CEO of WCCHC, many complaints have been raised since QExA went into effect Feb. 1. While the WCCHC is one of three centers in Hawaii to hold out on signing with the plan, more than 2,000 patients at the West Oahu health center now are covered by the managed-care program for the elderly, disabled and blind.

“The Mainland for-profit companies that run these plans have drawn many complaints in other states. We should at least ask questions about their history,” Bettini said.


AlohaCare was the previous health plan provider for WCCHC, but when its bid on the program was reportedly turned down, patients were less than happy with the change.

“I like the way things were when we had AlohaCare,” said Sarah Naylor.“I’ve been with the same doctor for 16 years, and my daughter (has been) for 15 years of her life.”

“Our doctors know each and every one of us here personally,” added James Naylor. “Do you want to go to someone you don’t feel comfortable with? I don’t want that, and I’m not going to have that.”

Other issues concerning misguided information in the plan’s handbooks and the lack of choices also were brought up at the meeting.

WCCHC currently operates as an out-of-network provider and has until April to choose among four options. Bettini proposed that they can sign the contract with QExA as is; no longer provide service for the center’s 2,400 patients; continue as an out-of-network provider but risk delaying reimbursements and health access; or continue to raise questions and wait for a legislative bill to allow Waianae and Waimanalo health centers to be exempt from the QExA program.

“We’re doing our due-diligence as medical providers,” Bettini explained. “Our decision to sign on will be based on whether this plan is pono for our community.

“The decision will be made by all of us.”

A second QExA Town Meeting will be held at 6:30 p.m. Tuesday (March 17) in the WCCHC Dining Pavilion. QUEST administrators are invited to attend to hear concerns from affected patients.

For more information regarding the health center, the QExA program or for updates, e-mail .(JavaScript must be enabled to view this email address) or call 697-3457.

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