Iindleko ezahlukeneyo zeeMvavanyo ezifanayo
Umele ulindele ukuhlawula inani elifanayo kwiinkonzo zononophelo lwempilo kungakhathaliseki ukuba wenze ntoni. Okumangalisa kukuba, i-Medicare ayizange ibambelele kule migaqo. Amaziko e-Medicare kunye neMedicaid sele ehlawulela amasebe esibhedlele angaphantsi kweemvavanyo ezifanayo kunye neenkqubo ezingenziwa kwiofisi yakho yogqirha. Oku kungathi ukutshintsha.
Ziziphi iindawo ezingathathi hlangothi?
Xa udinga ukuvandlakanywa, ugqirha uya kuyala iimvavanyo. Ukuba ugqirha wakho unxulumene nesibhedlele, ungathunyelwa kwisibhedlele sonyango esibhedlele ukuba uwenze. Enyanisweni, oku kungakubiza kakhulu.
Iofisi yakho yogqirha inokukwazi ukunikela iimvavanyo ezifanayo ezibonelelwa kwiSebe lezezibhedlele ezingaphandle. Ngokomzekelo, abaninzi beeprodiologists bangenza i- echocardiograms kunye novavanyo loxinzelelo kwiofisi yabo. Amanye oogqirha bama-orthopedic angaba ne-x-ray kwi-site ukujonga iifractures . Amagumbi okuhlinzwa angabandakanyeka angakhuphisana nezibhedlele ezithile iinkqubo ezinobungozi obuphantsi.
Njengoko ngoku imi, kwiimeko ezifanayo zekliniki, i-Medicare ihlawula ngaphezulu iinkonzo ezenziwa kwiiminyango zesibhedlele ezingaphantsi kwezi ndawo. Oku kunjalo nangona kungadingeki ukuba sisibhedlele. Ukubeka nje, umgangatho wokunyamekela awufani nendawo enye ukuya kutsho.
Ngokutsho kweKomishoni ye-Medicare Payment Advisory (i-MedPAC), i-Medicare ihlawule izibhedlele ezingaphantsi kwezibhedlele ziphantse ziphindwe kabini inani lemali ye-echocardiograms ngo-2013. Ngaloo nyaka, amaziko okuhlinzekwa ngogqirha ahlawulwa malunga nama-78 ekhulwini ngaphantsi kweenkqubo eziphantsi kweengozi ezenziwa esibhedlele ukuseta.
Indlela iNdawo yokuThengwa kweNtlawulo engeyona nto ithintela ngayo i-Medicare
I-MedPAC icebise ukuba iintlawulo zeenkqubo ezifanayo kwiimeko zonyango eziphambili zihlawulwa yi-Medicare ngamaxabiso afanayo. Ezi ntlawulo ze-site ezingathathi hlangothi ziya kusindisa zombini kunye neMali ye-Medicare.
I-Ofisi yoMhloli-Jikelele kutshanje iqikelele ukuba iirhafu zokuhlinzwa ezithintekayo kulabo abahlawulwa kwiziko lokuhlinzwa ngokugqithiseleyo zingasindisa iMedareri nge-$ 15 billion ngaphezu kweminyaka emihlanu. Iintlawulo ze-Site-hlangothi zinganciphisa iintlawulo ze-Medicare kwizibhedlele ngama-1.44bhiliyoni ngonyaka ngamnye, ngokweMediaPAC.
Indlela iNdawo yokuThengwa kweNtlawulo engeyona ndawo ithinte ngayo izibhedlele
I-American Hospital Association (AHA) iphikisana neentlawulo ezingathathi hlangothi. Bakhankanya ukuba amasebe asebhedlele angaphantsi abone inani elingafaniyo labantu abakwiMedicaid , abantu abanamalungelo afanelekileyo (kokubili i-Medicare kunye neMedicaid), kunye nabantu abangaqinisekanga. Ngezigulane ezingenayo imali engenakukwazi ukuhlawula isabelo sawo, ukuba utshintsho kwiindawo ezingahambisani neendawo zingakhokelela ekuhlaleni ixabiso lokubuyisela izibhedlele.
Izigulane zeMedare ezisebenzisa izibhedlele zesibhedlele zangaphandle zihlala zinezifo ezingapheliyo zonyango. Ingozi eyongeziweyo yeengxaki kwizi gulane kufuneka ithathelwe ingqalelo.
I-AHA iphawula ukuba ngenxa yezi gulane eziphezulu zengozi, amasebe asebhedlele angaphandle ayenako ukuba nomongikazi ngaphezu kwonyango ochaphazelekayo kwiimeko ezahlukeneyo zokuvavanya. Oku kwongeza kwiindleko eziphezulu zezi zifundo.
Izibhedlele zimele zilahlekelwe zizigidigidi ukuba iintlawulo ze-intanethi zingeneli. Ukulahlekelwa kwengeniso kungabangela ukuba izibhedlele zenze iinguqu zemali zenze utshintsho, mhlawumbi zichaphazele abasebenzi kunye neminye imibandela yokufikelela.
Indlela iNdawo yokuThengwa kweNdawo engeyona nto ithintela ngayo
Iintlawulo ezingathathi hlangothi ziya kukugcina imali xa unakekelwa kwisebe lesibhedlele esilula. Emva koko, uhlawula uvavanyo olufanayo kunye nomgangatho ofanayo wokunyamekela.
I-caveat kukuba le nguqulelo yomgaqo-nkqubo iyakwazi ukuza neenguqu ekufikelelekeni. Ukunciphisa ingeniso yesibhedlele kungenza kube nzima ukufikelela kwiimvavanyo ezithile.
Imithombo
American Hospital Association. Ukuthelekiswa koNonophelo kwiSebe lezeMpilo eziPhezulu kunye neeOfisi zonyango. http://www.aha.org/content/15/hopdcomparison.pdf. Epapashwe ngoFebruwari 2015.
IKomishoni yokuHlawuleka yeMali. Bika kwiNgqungquthela: UMgaqo-nkqubo weNtlawulo weMali. http://www.medpac.gov/documents/reports/mar2015_entirereport_revised.pdf?sfvrsn=0. Kushicilelwe ngoMatshi 2015.
Ofisi yoMphathi Jikelele. I-Medicare kunye nabaxhamli bangakwazi ukugcina iiBhiliyoni Ukuba i-CMS iyanciphisa iSibhedlele seZibhedlele eziPhezulu kwiiNkokhelo zokuThatyathwa kweeNkqubo zoVavanyo eziVunyiweyo zeZiko lokuThengisa. http://oig.hhs.gov/oas/reports/region5/51200020.pdf. Epapashwe ngo-Ephreli 2014.