Iimiphumo ezingenabangozi zoMthetho woNonophelo ojongene noNcedo
Ekubeni uMthetho woNonophelo ongenakunyanzeliswa wenziwa ngo-2010, i-Medicare iyenze utshintsho lokulawula kwiindleko. Ezi zinguqu zinokuba nemiphumo engalindelekanga yenkathalo oyifumana esibhedlele.
Indlela YeeNkqubo zokuNcitshiswa kweeNkqubo zokuFunda
Ngo-Oktobha 2012, ii-Centres ze-Medicare neMedicaid zaqala ukuhlawulisa izibhedlele ezineenani eliphezulu zezigulana ezibuyiselwa ukungena kwiintsuku ezingama-30.
Inkqubo Yokunciphisa UkuFunda, eyenziwe phantsi koMthetho woNonophelo ongenakunqwenelekayo, ukhangele ngqo kwi-admission ye- heart attack , ukuhluleka kwentliziyo , ukunyuka kwesifo se- pneumonia , ukuguqulwa kwamadolo, ukuguqula amadolo, kunye nesifo esingavimbayo se-pulmonary disease (COPD) .
Ngeentlawulo ezincitshisiwe ezinokuphakama kweepesenti ezintathu, ezi zihlwayo zingabangela izigidi zeedola ezilahlekileyo kwizibhedlele. Ngonyaka-mali ka-2016 (Oktobha 1, 2015 ukuya kuSeptemba 30, 2016), izibhedlele ezi-2,592 ziya kulahla i-$ 420 yezigidi kwiintlawulo ze-Medicare ezisusela kule nkqubo yodwa.
Indlela yoLawulo lwe-2-Midnight Night isebenza ngayo
Ngo-Oktobha 2013, uMthetho ojongene noNonophelo ongenakunqunyulwa ushintshile indlela u-Medicare egubungela ngayo isibhedlela sakho. Esikhundleni sokusekela i-coverage yakho malunga nokuba ugula kangakanani, isisiseko sokuba ungakanani esibhedlele. Icandelo A liqala ukusebenza kuphela xa uhlala kwakho uwela emibini. Oku kwaziwa ngokuba ngu- 2-Midnight Rule . Xa ungahlangabezane nale miqathango, ubeka "phantsi koqwalaselo."
Ukugcinwa kokuqwalasela kuye kwanyuka ukususela ekubeni isigqibo senziwa. Ngokutsho kweMedPac, "Inani leeyure zokuqwalasela (zombini zihlanganiswe kwaye zihlawulelwe ngokwahlukileyo) zanda kakhulu, ukusuka kwii-miliyoni ezili-23 ngo-2006 ukuya kwizigidi ezingama-53 ngo-2013."
Oku kuchaphazela njani okuhlawulayo
Xa uyangeniswa esibhedlele njengesigulana, izibonelelo zakho ze-Medicare Part A ziqala ukusebenza.
Uhlawula isaphulelo esicatshulwayo sokuhlala kwakho okufikelela kwiintsuku ezingama-60. Oku kuya kuhlawula ixabiso elingaphantsi kunokuba uza kuhlawula ukuba i-Medicare Part B yakho-inshorensi yonyango - uyihlawule ibhili-mali yokuhlala. Oko kwathiwa, Icandelo A lihlawule iindleko zorhulumente ngaphezulu.
Icandelo A lihlawula ixesha lokuhlala esibhedlele kunye neCandelo B lihlawula ukuhlala.
I-logistically, uhlawula imali ehlukeneyo kwenkathalo efanayo kuxhomekeke kwindlela esibhedlele sakho esihlala ngayo sibhalwe. Ngaba unokukhetha ukuhlawula iRadio ye-1,288 ye- A ye-deductible okanye i-20 ekhulwini yazo zonke iindleko zesibhedlele kwiNgxenye B ?
Indlela okuchaphazela ngayo iSibhedlele sakho
Izibhedlele zijolise ekukhuseleni ukufunda kunye nezohlwayo ezixabisekileyo. Nge-2-Midnight Rule Rule kunye nokwanda kwimizuzu yokugcina, oku kungabanika inzuzo. Ukugcinwa kokugcinwa akuyi kubala kwi-metric yokufunda. Abanye bacinga ukuba izibhedlele zidlala le nkqubo ngokubeka izigulane phantsi kwemeko yokujonga ukuguqula iintlawulo.
Nangona kunjalo, izibhedlele nazo zifuna ukubuyiselwa kwiinkonzo zabo. Inyaniso kukuba izibhedlele ziyakwazi ukufumana inkokhelo evela kwi-Medicare kunokuba bathathe inzuzo abazuze ngaphantsi abangakwazi ukuwufumana . Izibhedlele ziyakwenza uncedo olungakumbi kubantu abasemagunyeni abakwamkelwayo ngenxa yokugcinwa kokubona.
Umbuzo akufanele ube yiziphi izibonelelo esibhedlele ngaphezulu kodwa ukuba ufumana ukunyamekela okufanelekileyo, okunokubakho okuthengekayo okusekelwe kwiimfuno zakho zonyango.
Ukuba unenye yeemeko zonyango ukuba uphononongo lweeNgxelo zokuNciphisa ukuFunda, unokufuna ukuthetha nababoneleli bakho bezempilo ukuze uqiniseke ukuba i-oda lakho lokumkelwa lifanelekileyo.
Imithombo
Amaziko e-Medicare kunye neMedicaid. Inkqubo Yokunciphisa Ukufunda. https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/readmissions-reduction-program.html. Ukuhlaziywa ngoNovemba 16, 2015.
Ikomidi elijongene neNtlawulo yezeMali. UkuNakekelwa kweMpilo kunye neProgram yeMedare. http://www.medpac.gov/documents/data-book/june-2015-databook-health-care-spending-and-the-medicare-program.pdf. Yashicilelwe ngoJuni 2015.
Rau, J. Half yezibhedlele zeSizwe aphumeleli kwakhona Ukuphepha kweeNkundla zokuFunda zeMedare. Kaiser Health News. http://khn.org/news/half-of-nations-hospitals-fail-again-to-escape-medicares-readmission-penalties/. Ipapashwe ngo-Agasti 3, 2015.