Ukunyuka kweMfuno kuguqulelwa kwimali engaphezulu kweeNkliniki ezininzi
Njengokuba abaqeqeshi bezempilo bebengekho kwiimfuno eziphezulu, imithombo emininzi ibhekisela kwimimandla ebonisa ukuba uMthetho ojongene noThathaka ( Affordable Care Act ) uqhubeka ukwandisa imfuno yabasebenzi bezempilo. I-ACA, ekwabizwa ngokuba yi-Obamacare okanye ukulungiswa kwempilo, yinkalo ephakamileyo yeemfuno ngokugqithiseleyo oogqirha kunye nabongikazi, kwaye mhlawumbi kubangele ukusweleka kwiindawo ezithile zeli lizwe, ingakumbi kwiinkonzo zokunakekela iiprayimari.
Izizathu zokuba kungani i-ACA ifuna ukwandiswa kwemfuno yabaSebenzi bezeMpilo
Enye indlela i-ACA yokwandisa imfuno kukunciphisa inani labantu abakwilizwe abangaqinisekisiwe ngumgaqo-nkqubo wokunakekelwa kwezempilo. Ngokunyusa izinga le-insured, oku, ngokukodwa, kwakha isidingo esongezelelweyo seenkonzo zonyango. Imithombo ethile, kuquka iYunivesithi yaseBradley, ingxelo ngezinga elingagqitywanga liphantsi kwe-9.2 yeepesenti, eli lizinga eliphantsi kakhulu kwiminyaka engama-50. Ingxelo yabo malunga nefuthe le-ACA kwabasebenzi abahlengikazi kunye nabhaliso lwabafundi besikolo sabahlengikazi bathi "ukuphunyezwa kwe-ACA kubonisa ithuba elingakaze lenzeke kwi-APRNs (abaPhuhlileyo abaPhezulu abaBhalisiweyo) ukuba bathathe iimbopheleleko zobunkokeli ekunikeni ukunakekelwa okuphambili nokuqinisa iinkonzo zokuthintela . "
Kwakhona ukukhula ekuthandeni nasekufuneni kuyinkqubo yezobuhlengikazi (DNP), ngokutsho kweYunivesithi yaseBradley. Ingxelo ithi, "Abagqirha be-Nursing Practice Practice (DNP) abahlengikazi baye baqhubela phambili ulwazi lwezopolitiko kunye nezakhono zokukhuthaza," kubhala ukuba abafundi abayi-18,352 ababhalise kwiiprogram ze-DNP ngo-2013-2014.
Ukukhula kwiNkcazo yeMpilo yengqondo
Ukongezelela kokunqongophala kwintsimi yokunakekelwa kweprayimari, ukunakekelwa kwempilo yengqondo kuvakalelwa kwakhona ukunyanzeliswa kwabasebenzi, ekuvukeni kwe-ACA. Ukuncedisa ukuhlangabezana neemfuno ezikhulayo, izikolo ezininzi zinokwandisa iiprogram zee-degree kwiingcebiso kunye nempilo yokuziphatha. Ngokutsho kweYunivesithi yaseBradley, phantse ihafu (47.4 pesenti) yamaMerika iya kuba nolunye uhlobo lwezempilo yengxaki ebomini babo.
Isantya sokugula kwengqondo eUnited States siphakathi kwezona ziphezulu kwihlabathi, ngokutsho kweNational Health Organization (WHO).
Iinkqubo zeKlinikhi eziPhambili
Abaqeshi abaninzi kunye namaziko okunakekelwa kwezempilo aphendukela kubanikezeli bezakhono eziphambili, njenge-NPs (abahlengikazi) kunye ne-PAs (abancedisi boogqirha) ukuncedisa ukufunwa kwimeko yokunakekelwa kwinqununu kunye nokuziphatha kwempilo. Amakliniki asebenzayo asemaphandleni sele sele efumana i-spike kwiimfuneko kunye nokuqeshwa kwemisebenzi, inani leenkampani zokuqeshisa zibika. Ngokomzekelo, i-Medicus Firm, ugqirha welizwe kunye noogqirha oluphambili lokukhangela inkampani, uye wabonisa ukwanda okwenziwe kumsebenzi wokubeka ababoneleli ngonyango ngo-2014 no-2015, ngokwemibiko yabo yesishwankathelo sonyaka sokuqeshwa komsebenzi wesizwe. Ngo-2015, ukunikezelwa kwabanikezeli bezakhono eziphambili kwanda ukuya kuma-8.3 ekhulwini lwabathengi abahlala kulo lonke ilizwe, ukususela kuma-6.34 ekhulwini kunyaka odlulileyo, kunye ne-1,32 ekhulwini ngo-2012. Ngo-2015, abaNcedisi beeNgcaciso babesibonelelo sesine esinikezelwa rhoqo ngabaxhasi be-Medicus Firm .
Ukunyuswa kweMfuno eYongezelelweyo Impembelelo yoNyango lwezeMpilo kwaKliniki
Ngenxa yokwanda kweemfuno kunye nokungabikho kokunqongophala kubakho umvuzo wokunyuka kwemivuzo.
Imfuno kunye nemivuzo yabanogqirha kunye neekliniki eziqhutywe phambili ziye zenyuka phezulu iminyaka emininzi. Ukongezelela, ukusabalala kokubhalisa ibhonasi kuye kwabangela ukuba i-perk ibe ilindeleke ukuba ugqirha xa uqeshwa, ubuncinane ubuncinane kuma-70 eentengiso ezibandakanya ibhonasi yokutyikitya. Ingxelo yengxelo ye-Medicus Firm, ibhonasi yesigqirha yesigqirha ikhule ibe malunga ne-$ 23,663, kwaye ezinye iingcali ziyala amabhonasi angama-6 000 ukuya kwii-250,000 zamaRandi.
Kungekudala, ukusayinwa iibhonasi ze-NPs kunye nee-PA kwakungabonakali, kodwa kungekudala ukusetyenziswa kwebhonasi zokusayina ukunyenga amayeza asetshenziselwa ukuqhuba umsebenzi uya kuba yindawo eqhelekileyo.
Ibhonasi yesayinithi ye-PAs yayingama-$ 6,250 ngo-2015, ngaphezu kokuphindwe kabini kwi-3,000 ye-average yeeminyaka emibili ngaphambili.
Ukongeza ngaphezu kokusayinela ibhonasi, iiphakheji zokuthutha zinikwa ukuncedisa iindleko zokufudukela kwintlalo entsha, kwaye ukuhlawulwa kwemali-mboleko yeso sifundo kuqhutyelwa ngamagqirha, abahlala beqala imisebenzi yabo nge $ 150,000-$ 250,000 kumatyala-mboleko.
Azikho zonke ezi zinto zibangelwa ukulungiswa kwempilo. Ngenxa yokuguga kunye nentuthuko yezokwelapha, imfuneko yokunakekelwa kwempilo yayisele iphakame, kwaye ukuphunyezwa koMthetho wokuNakekelwa ongenakunokuthi unokunyusa ukwanda kwemfuno ngokuvumela abaninzi baseMelika ukuba bafumane i-inshorensi yezempilo. Nangona kunjalo, kwezinye iindawo ezisemaphandleni, ngokukodwa kwimimandla efunekayo ephakamileyo ekhankanywe ngasentla njengokhathalelo oluphambili, kunye nempilo yokuziphatha, ukufumana ingqalelo akusoloko kuqinisekisa ukufikelela kudokotela , ngenxa yokunqongophala kwiindawo ezininzi kunye nezinye izinto ezizodwa. Ngoko ke, ukwandisa ububanzi bezonyango eziphambili kunye nokufumana ezinye iindlela zokwandisa ukufikelela kwababoneleli (i-telemedicine, njl.) Kubaluleke kakhulu ekuhlangabezaneni nemfuno yeenkonzo zonyango.
Iingcali zonyango ziqhubekela phezulu
Imivuzo yabagqirha yabonisa ukwanda kwezona zodwa ezizodwa ze-2015, ngokwemibiko ye-2016. I-Association Group Management Association (MGMA), kwakunye neefesithi ezininzi zokuqashwa, zichaze indlela yokunyuka kwemivuzo yonyango kwiindawo ezininzi ezizodwa ukusuka ngo-2014 ukuya ku-2015.
Iziphumo zemivuzo ye-Medicus Firm ibonise ukwanda kwinqanaba lokuqala kwangoko, ngokutsho kukaJim Stone, umongameli. "Zonke iindawo ezizodwa zichaze ukwanda ukusuka ngo-2014 kuya ku-2015, okokuqala ngophando lwethu lwangonyaka," watsho. "Nangona iimivuzo zineziphumo eziphezulu ezithe zaphakanyiswayo kwiminyaka embalwa edluleyo yolu vavanyo lwemali yonyaka, kukho iminyaka embalwa ebonisa izinga lokukhula kancinci, kwaye kwanokuncipha kweengxelo ezithile kwiindawo ezithile. zonke iindawo ezizodwa ezibonisa ukunyuka okuqinile kwintlawulo, "itye yagqitywa.