Number Of CNMI Medical Referrals Down, Costs Up

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More than $6.3 million spent for off-island care in FY2014

By Jayson Camacho

SAIPAN, CNMI (Saipan Tribune, Nov. 19, 2014) – Despite a slight drop in the number of patients referred off-island for treatment in fiscal year 2014, the total cost spent for medical referral in that period increased by about $1.1 million compared to previous fiscal years.

According to Medical Referral Services director Ronald D. Sablan, his office spent a total of $6.374 million for medical referrals covering the period from Oct. 1, 2013, to Sept. 30, 2014.

In comparison, medical referral expenses in fiscal year 2012 totaled $5.483 million, increasing to about $5.274 million in fiscal year 2013.

Sablan said the increased cost reflects higher costs for airfare, subsistence, hotel accommodations, medical claims, patient reimbursements, and funeral expenses.

He said the costs of treating a patient off-island varies with expenses that can be either very expensive or less.

Patients referred off-island with the most expenses include cardiology, oncology, and mouth or throat cancer.

"These three are very expensive. The epidemic of mouth and throat cancer is new. Before, cardiology and oncology were the most expensive," Sablan said.

Generally, these procedures cost $25,000 but the same procedure can even cost more elsewhere such as in Hawaii or the United States.

For fiscal year 2014 a total of 684 patients were medically referred off island: 349 were medically referred to Guam; 52 to Hawaii; 260 to the Philippines; 21 to San Diego, California; and two to Portland, Oregon.

This is a decrease compared to the 732 patients medically referred in fiscal year 2013. In that period, 442 were referred to Guam, 62 to Hawaii, 211 to the Philippines, six to San Diego, nine to Los Angeles, one to Portland, and one to San Francisco.

About 645 patients were referred in fiscal year 2012.

Broken down, a total of $1.1 million was spent on airfare in fiscal year 2014; $39,595 for subsistence; $1.655 million on hotel accommodations; $3.509 million on medical claims; $33,766 on patient reimbursements [for those who paid for their medical referrals], and $36,414 on funeral expenses [for those who passed during the medical referral off-island].

"Despite the tight budget and the high expenditure, patients always come first. We are usually the ones paying for a medically referred patient for all accommodations. Sometimes, if they have a high annual salary, they can compromise and pay for some of what they can. But usually we pay for it," Sablan said.

This new fiscal year, which kicked in on Sept. 30, MRS received a decrease in its budget. The budget given for this year was $2.67 million and about $2 million will be spent for medical expenses.

"We try do as much as we can and can’t expect it to be done right away. If they qualify for medical referral, then no one is left behind. It’s just the budget appropriations every year and the Legislature needs to understand that budget is necessary when it is requested by medical referral," Sablan said.

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