Imiphumela engenzi lutho Yomthetho Wokunakekelwa Onganakekelwayo
Njengoba uMthetho Wokunakekelwa Okungenakusiza unqunywe ngonyaka wezi-2010, uMedarele uyenze izinguquko zokubusa ezindlekweni. Lezi zinguquko kungenzeka ukuthi zinezimo ezingalindelekile zokukhathalela ozithola esibhedlela.
Indlela Uhlelo Lokunciphisa Ukufundwa Kwe-Readmissions Lisebenza
Ngo-Okthoba 2012, amaCenter for Medicare and Medicaid aqala ukuphulukisa izibhedlela ezinenani eliphezulu leziguli ezibuyiselwayo zingakapheli izinsuku ezingama-30.
Uhlelo lokunciphisa ama-Readmissions, oludalwa ngaphansi koMthetho Wokunakekelwa Ongenakusiza, lubheka ngokuqondile ukuvuma kwe- heart , ukuhluleka kwenhliziyo , ukuphazamiseka kwe- hip / knees, nesifo se-chronic obstructive pulmonary (COPD) .
Njengoba izinkokhelo ezincishisiwe ziphakeme ngamaphesenti amathathu, lezi zijeziso zingabangela izigidi zezigidi ezilahlekile ezibhedlela. Ngonyaka wezimali 2016 (Okthoba 1, 2015 kuya kuSeptemba 30, 2016), izibhedlela ezingu-2 592 zizolahlekelwa imali eyizigidi ezingamaRandi ezingu-420 ezikhokhweni zikaMedare ngokusekelwe kulolu hlelo kuphela.
Yeka ukuthi uMthetho we-2-Midnight usebenza kanjani
Ngomhla ka-Okthoba 2013, uMthetho Wokunakekelwa Ongenakusiza wawushintsha indlela uMnyango wezempilo owawugubha ngayo ukuhlala esibhedlela. Esikhundleni sokusekela ukuthi ugule kangakanani, kuyisekela ukuthi uhlala esibhedlela isikhathi esingakanani. Ingxenye A iqala ukusebenza uma ukuhlala kwakho kudlula ezimbili. Lokhu kuyaziwa ngokuthi yi- 2-Midnight Rule . Uma ungahlangabezane nalezi zinqubo, ubeka "ngaphansi kokubheka."
Ukuhlala okuqaphelile kuye kwavela njengoba isinqumo sisebenza. Ngokusho kukaMedPac, "Inani lamahora okubuka (kokubili okuhlanganisiwe futhi ekhokhwa ngokwehlukana) liye landa kakhulu, kusukela ezigidini ezingaba ngu-23 ngonyaka ka-2006 kuya ku-53 million ngo-2013."
Indlela Lokhu Okuthinta Ngayo Okukhokhayo
Uma usungenwe esibhedlela njengesiguli, izibonelelo zakho ze-Medicare Part A ziqala ukusebenza.
Ukhokha i-flat deductible yokuhlala kwakho okuhlanganisa izinsuku ezingu-60. Lokhu kuhloswe ukuthi ukhokhe imali engaphansi kwalokhu ongayikhokha uma i-Medicare Part B yakho - umshuwalense wezokwelapha - ukhokhele umthethosivivinywa ukuze uhlale unakekele. Lokho kusho ukuthi, Ingxenye A ivame ukubiza uhulumeni ngaphezulu.
Ingxenye A ikhokhela ukuhlala esibhedlela futhi Ingxenye B ikhokhela ukuhlala kokubona.
Ngempela, ukhokha imali ehlukile yokunakekelwa okufanayo kuye ngokuthi ukuhlala esibhedlela sekubhalwe kanjani. Ungathanda ukukhokha u-$ 1,288 Ingxenye A deductible noma amaphesenti angu-20 azo zonke izindleko zesibhedlela ngeNgxenye B ?
Indlela Lokhu Okuthinta Isibhedlela Sakho Hlala
Izibhedlela zihlose ukugwema ukufunda kanye nezijeziso ezibiza kakhulu. Nge-2-Midnight Rule kanye nokwandiswa kokuhlala kokubona, lokhu kungabenza kube lula. Ukuhlala okuqaphele akubhekiseli kumetrikhi yokufunda. Abanye bayazibuza ukuthi izibhedlela zidlala yini uhlelo ngokubeka iziguli ngaphansi kwesimo sokubheka ukuguqula izinhlawulo.
Nokho, izibhedlela nazo zifuna ukubuyiselwa izinsizakalo zabo. Iqiniso liwukuthi izibhedlela zingase zithole inkokhelo evela ku-Medicare kunabanye abazuzayo abahola kancane abahluleka ukuyikhokhela . Izibhedlela zingase zithole inzuzo ngaphezulu kokungenwa kweziguli ezingaphezu kokugula.
Umbuzo akufanele ube yiziphi izinzuzo esibhedlela ngaphezulu kodwa ukuthi uthola ukunakekelwa okufanele, okungabizi kahle ngokusekelwe kwezidingo zakho zezokwelapha.
Uma unesinye sezimo zezokwelapha ukubuyekezwa kohlelo lokunciphisa ama-Readmissions, ungase ufune ukukhuluma nabahlinzeki bakho bezempilo ukuze uqiniseke ukuthi ama-oda akho wokuvuma afanelekile.
Imithombo
Amasevisi we-Medicare ne-Medicaid. Uhlelo lokunciphisa ama-Readmissions. https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/readmissions-reduction-program.html. Kubuyekezwe uNowa 16, 2015.
IKomidi Elilulekayo Lokukhokhelwa Kwemithi. Ukunakekelwa Kwezempilo KwezeMpilo kanye neNhlelo Yezokwelapha. http://www.medpac.gov/documents/data-book/june-2015-databook-health-care-spending-and-the-medicare-program.pdf. Kushicilelwe ngo-June 2015.
Rau, J. Half Of Izibhedlela Zesizwe Ahluleka Ukuphinda Abalekele Izigwegwe Zokufunda zikaMedare. I-Kaiser Health News. http://khn.org/news/half-of-nations-hospitals-fail-again-to-escape-medicares-readmission-penalties/. Ishicilelwe ngo-Agasti 3, 2015.