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CNMI hospital director outlines expanded cancer, imaging and dialysis services and warns of Medicaid cap shortfalls
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Summary
CHCC CEO Dr. Esther Munoz told APIL that CNMI’s public hospital and clinic network has expanded oncology, lab and dialysis services and is adding MRI and hyperbaric capacity, but that fixed federal Medicaid caps and workforce shortages constrain service access and sustainability.
Dr. Esther Munoz, chief executive officer of the Commonwealth Healthcare Corporation (CHCC), briefed APIL delegates on CNMI health services, capital projects and financing challenges.
CHCC operates the hospital on Saipan and outpatient and specialty clinics across Saipan, Tinian and Rota. Dr. Munoz highlighted CHCC’s recent grants and projects: expansion of laboratory services on all three islands, a donated MRI and a hyperbaric chamber facility under construction, and a planned medical‑supply warehouse and multi‑level parking structure. She said grants also funded a new electronic health record implementation planned to go live in 2026.
On care access, CHCC reported investments in oncology services and telehealth consultations with outside specialty centers to reduce off‑island referrals. Dr. Munoz said CHCC has increased in‑island treatment capacity for some cancers and aims to expand dialysis options and peritoneal dialysis training for outer‑island patients.
Financing remains a central challenge: Dr. Munoz described a historic Medicaid shortfall and the constraints of Section 1108 territorial Medicaid caps, and said CHCC receives the federal portion of reimbursements only (a shortfall in local matching funds persists). She said earlier congressional action produced one‑time federal transfers to reduce a shortfall but urged continued congressional attention to predictable funding and expanded coverage items.
Dr. Munoz thanked the CNMI legislature for recent laws supporting food‑security research, licensing flexibility for foreign medical providers and a charitable foundation to help finance services. She said workforce shortages persist after the pandemic and retention and recruitment remain priorities.
Delegates asked about telehealth and interstate arrangements that could allow patients to access U.S. state facilities without exhausting local Medicaid caps. CHCC said the health network continues to manage medical referrals and seeks agreements to improve access and reduce off‑island costs.
CHCC requested technical cooperation on workforce development, telehealth billing and Medicaid policy design and welcomed bilateral follow‑up from partners and neighboring legislatures.
