Dr. Katie Min was 36 when she took over her father’s primary care practice in the Queen’s Physicians Office Building in Honolulu’s Punchbowl neighborhood in 2022. Min’s father had taken the practice over from his father, who had started it in the 1940s.Now after three generations, Min says the multigenerational practice is facing an existential financial threat after the state’s largest insurer gave her 60 days’ notice that it was radically changing its reimbursement model for primary care doctors. Starting on July 1, the insurer will stop paying a set monthly fee for each patient under a doctor’s care and revert to the way it paid doctors a decade ago: fees for individual services rendered. While some doctors preferred the older model, the rapid change to a system many had already adapted to is destabilizing — particularly for smaller practices operating on thin margins already.
Min estimates she’ll lose at least $50,000 annually for her practice, which will put her practice on the ropes financially when factoring in another big blow that came in late 2025, although she says she’s determined to find a solution.
“Some of these patients have been cared for by my family for 50 years,” she said. “I’m honestly getting a little tearful about it.” Regardless, the announcement has sent shock waves through the medical community, particularly among those on the front lines of treating patients — primary care doctors who are already in alarmingly short supply, particularly on neighbor islands.
