Drs. Calvin C.J. Sia and Galen Y.K. Kwock clearly outlined the negative effects of HMSA’s payment transformation (PT) on the medical home concept, widely recognized as a model for all primary care, especially in pediatrics (“Family-centered medical home eroding,” Star-Advertiser, Island Voices, July 14).

Then, Dr. Mark Mugiishi of HMSA described PT as an important solution to control health care costs and necessary for a healthier Hawaii (“Dr. Mark Mugiishi,” Star-Advertiser, Name in the News, July 19).

In reality, pediatricians in Hawaii have always provided high-quality care at likely the lowest cost in the nation.

Ironically, it was Sia who inspired the adoption of the medical home concept here (as well as nationwide) that is now being undermined by HMSA.

One glaring example: HMSA no longer reimburses pediatricians for providing vaccinations (or office testing) for serious infectious diseases, demonstrating its apparent disregard for the value of comprehensive preventive primary care in our population.

Harold Nilsson, M.D.

Ala Moana

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