Hawaiis health care system specifically tailored to serving Native Hawaiians is shutting down its primary care clinic in Hilo next month.

Hui Malama Ola Na Oiwis multiple other services, including community outreach, case management, health education and transportation, will continue to operate, but the primary care clinic at 305 Wailuku Drive will close March 8.

Hui Malama Executive Director Michelle M. Hiraishi said Wednesday that the private nonprofits board opted to close the clinic last month after years of struggling with withering finances and a crippling doctor shortage.

Weve been dealing with this, struggling to maintain our clinic, for many, many years, she said. All the community health providers have been facing this kind of struggle.

With an average of 400 patient visits a month, about 78 percent of Hui Malamas primary care clients are covered by Medicare or Medicaid, with 2 percent being uninsured, she said.

Unlike traditional community health centers, which enjoy higher reimbursement rates from Medicare and Medicaid, Hui Malama must cover its costs as if it were a private practice, Hiraishi said, severely cutting into its revenues.

Meanwhile, the clinic has had to deal with the severe doctor shortage that other providers on the island continue to face. Hui Malama has largely relied on advanced practice registered nurses to keep the clinic staffed, but that means that many of the patients who come in with advanced illnesses must be referred on to other providers.

At times, weve been able to get an MD-level provider on board, but we just have not been able to retain them usually, Hiraishi said.

The nonprofits board ultimately decided, after several attempts to keep the clinic in operation, that it would be best to keep Hui Malamas focus centered on outreach and education efforts, rather than on providing primary care, she said.

It was a really, really lousy, hard decision for our board to have to make, and it came after five years of trying something else every time. We were just struggling to survive, she said.

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Native Hawaiian health care provider closing Hilo clinic