Izinyathelo Ezinhlanu Zokulungiselela Ukuguqulwa Kwezempilo KweNyaka Omusha

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Joyina i-ACO

I-ACO noma i-Accountable Care Organisation ingenye yezindlela ezihamba phambili okwamanje. Le model yokunakekelwa kwezempilo ithembisa ukuletha imiphumela engcono yeziguli ngamanani aphansi. Ukujoyina i-ACO kuye kwazuza ukusebenzisana okukhulu phakathi kodokotela okuye kwaholela ekuthuthukiseni izinga lokunakekela iziguli. Kodwa-ke, umphumela omkhulu ama-ACOs athembisa ukuthi uzoletha ukunciphisa okukhulu kwezindleko zezempilo ezingakabonakali.

I-ACO iphinde imele imodeli yezimali ezivuza inani ngokuphambene namamodeli wokukhokha wendabuko agxile kumthamo wezinsizakalo ezinikeziwe.

Njengoba i-ACO ingumqondo omusha embonini yezokwelapha, kusadingeka ukuthi ufunde okuningi mayelana nomthelela wesikhathi eside embonini yezokunakekelwa kwezempilo njengamanye kanye nabahlinzeki ngabanye kanye neziguli.

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Gxila ekunakekeleni ukuphepha nokuphepha

Izinhlelo ezintsha zomshuwalense wezempilo ezinama-deductibles aphezulu kanye nezindleko zezikhwama zeziguli zingadinga abahlinzeki ukuba bagxile kakhulu ekunakekeleni nokuphepha kahle. Njengoba iziguli zithatha ingxenye enkulu yokwelashwa kwabo, ukunakekelwa kokuvikela kuyoba kubaluleke kakhulu kubo.

Iningi lokunakekelwa kokuvimbela kanye nezinhlelo zezempilo kuhlelwa iziguli ngokusebenzisa umshuwalense wezempilo ngezinga eliphansi noma ngaphandle kwezindleko. Lokhu kunikeza ithuba labahlinzeki ukugxila amasu abo okukhangisa ekunakekelweni kokuvikela kanye nezinhlelo zokuhlanzeka ngokumelene nemithi ebiza kakhulu. Ukudla okunempilo, ukuzivocavoca kanye nokwehla kwesisindo kuyoba ngokwengeziwe kuneziguli.

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Phumelela Izinsizakalo zeTehealth

Indawo yokuncintisana yamasevisi we-telehealth iqala ukwanda ngokumangalisayo. Njengoba izinsizakalo zokunakekelwa kwezempilo ziqhubeka zithuthukiswa ngentuthuko kwezobuchwepheshe, ihhovisi lezokwelapha liyaqhubeka likwazi ukwandisa ukwaneliseka kwesiguli nokuthuthukisa izinga lokunakekelwa.

Ukubikezela kwami ​​ukuthi i-telehealth izoba ethandwa kakhulu ngenxa yokuguquguquka nokulula okuhlinzekayo. Yiqiniso, kuzoba nesidingo sokwelapha ngokomzimba iziguli ezizovakashela kodwa ezikwelapha ezilula, izinsizakalo ze-telehealth ziyaqhubeka njalo. Njengoba ukubuyiselwa kwemithethonqubo, imithethonqubo, kanye nokuvimbela ukuvimbela ukuqala, abahlinzeki abaningi kanye neziguli bazoqala ukuzuza kulobu buchwepheshe obusha.

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Thuthukisa izinga lokubekezela kanye namazinga okuphepha

Njengoba kushiwo ngaphambili, abakhokhisi abaningi bomshuwalense wezempilo basuke behambela umfelandawonye wezezimali eziwusizo ngokuphambene nomthamo wezemali wendabuko ogxile emthamo wezinsizakalo ezinikeziwe. Nakuba ukukhokha akuyona nje isizathu sokugxila kwizinga eliphezulu lesiguli kanye namazinga okuphepha, kuyisisusa sokukhuthaza ushintsho lwangempela ezinhlanganweni zokunakekela impilo ukuze ugxile ngaphezulu kwekhwalithi nokulingana.

Enye inzuzo yokuthuthukisa amazinga nezinga lokuphepha ukugcina idumela elikhulu. Emphakathini wanamuhla, idumela lakho le- inthanethi libaluleke nakakhulu kunedumela lakho le-intanethi. Nakuba izwi lomlomo lihamba ngokushesha, i-intanethi inokufinyelela okubanzi. Kubalulekile ukuthatha isinyathelo esenza ngcono ukwaneliseka kwesiguli , izinga lokunakekelwa, nokuphepha ukuze uthuthukise futhi ugcine isithombe esihle somkhuba wakho.

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Phinda uqale ukusebenza kwakho

Yonke imboni yezokwelapha iyashintsha ngokuhamba okusheshayo kuhlanganise neziguli ezidinga ukuthi ukwelashwa kuthuthuke ngokuqhubekayo ukuze kugcinwe ukunciphisa ukuncintisana. Ukwenza ukuhlolwa kukuvumela ukuba ubone amathuba okuthuthukisa.

Ngokujwayelekile, abaphathi kanye nabaphathi bacabanga ukuthi benza ukuhlolwa uma ihhovisi lezokwelapha linkathazo yezezimali, noma kunjalo, ukuhlolwa kungenziwa noma nini ukuhlola ukusebenza kwakho jikelele. Ukwenza ukuhlolwa manje kungavimbela ukukhokhela izindleko ezikhokhelwayo kamuva. Ukwaziswa okubuthayo kuzokukwazisa ngendlela okudingeka uyenze ngayo.

Isu eliphumelelayo yilona elithatha ihhovisi lezokwelapha phambili, liqondise isiqondiso esifuna ukuhamba njengoba indawo ngayinye yokugcizelela ithuthukiswa futhi isenziwa. Kudinga ukugxila nokuzinikezela kuwo wonke umuntu ohilelekile ngoba ithimba liqinile njengesixhumanisi sayo esibuthakathaka.