Ukuguga endaweni imboni yokuhamba kwamafutha
Ngokusho kweNational Association for Home Care and Hospice, ukunakekelwa kwekhaya kwaqala e-US ngawo-1880. Cishe abantu abayizigidi ezingu-12 manje bathola ukunakekelwa kwabahlinzeki abangaphezu kuka-33,000. Ngonyaka ka-2009, kwasetshenziswa imali yokunakekelwa kwempilo yonyaka ukuze ibe ngu-72.2 billion.
Uhlobo lomhlinzeki
"Izinhlangano zokunakekelwa ekhaya" zihlanganisa i-ejensi yokunakekelwa kwezempilo yasekhaya, izinhlangano zokusiza ukunakekelwa kwekhaya, kanye nesifo sokubeletha .
Ezinye zalezi zinhlangano ziqinisekiswe yi-Medicare, okuvumela abahlinzeki ukuba bahlawule i-Medicare ukuze babuyiselwe.
- Amaphesenti angaphezu kwamaphesenti angama-62 e-freestanding
- Amaphesenti angu-12 asekelwe esibhedlela.
Ama-ejensi wokunakekelwa ekhaya angaqinisekisiwe, izinhlangano zokusiza ukunakekela ekhaya, kanye nezibhedlela ezihlala ngaphandle kwe-Medicare zenza ngezizathu ezihlukahlukene. Ngokuvamile abahlinzeki ngobubanzi bezinsizakalo ezidinga uMedare, njengokunakekelwa kwabahlengikazi abanekhono.
Izinsizakalo
Izinsizakalo zezempilo zasekhaya zifaka:
- Imisebenzi yezempilo yasekhaya
- Imisebenzi Yomsebenzi Wezenhlalakahle
- Izinsizakalo Zokuhlengikazi
- Izinsiza Zokudla
- Izinsiza zokwelapha ngokomzimba
- Izinsizakalo Zezokwelapha Emsebenzini
- Izinsizakalo zokwelashwa zokuphefumula
- Izinsizakalo Zezokwelapha Zezinkulumo
- Izinto zokwelapha zasekhaya kanye nezinto zokusebenza
- Izinsizakalo zokuHlola ezokuPhathwa kweziMpilo
Ukusetshenziswa
Amaphrojekthi we-CMS athi:
- izindleko eziphelele zezwe zokunakekelwa kwezempilo ngo-2009 zaziyi $ 2.5 trillion.
- ukusetshenziswa kwemali ngabanikazi bentela kwanda ngamaphesenti angu-8.7 ngo-2009, ngokungafani nokukhula kwamaphesenti angu-3.0 ekusetshenzisweni kwabathengi abazimele.
- ukubhaliswa komshuwalense wangasese wehlile amaphesenti angu-1.2, okunciphisa ukukhula kwemali yokukhokhela abakhokhelwayo yangasese ngo-2009.
Abakhokhi
I-Medicare yiyona ekhokhayo enkulu kunazo zonke izinsizakalo zokunakekelwa kwezempilo ekhaya. Ngo-2009, ukusetshenziswa kweMedricare kwaba ngamaphesenti angaba ngu-41 ezempilo zekhaya.
Izinkokhelo ze-Medicaid zokunakekelwa kwekhaya zihlukaniswe ngezigaba ezintathu eziyinhloko: inzuzo yempilo yendabuko yempilo yasekhaya, nezinhlelo ezimbili zokuzikhethela, ukhetho lokunakekelwa komuntu siqu kanye nokwaziswa okusekhaya nasemphakathini.
Ngamanye, lezi zigaba ezintathu zokunakekelwa kwekhaya zimele ingxenye encane kodwa ekhulayo yenkokhelo yenani leMedicaid.
Izinsizakalo zokunakekelwa kwezempilo e-United States zixhaswa ngokwezimali ngokusebenzisa izinhlangano zokunakekela eziphethwe. Izinhlangano zokunakekelwa ezithintekayo , kuhlanganise nezinhlangano zokunakekelwa kwezempilo (ama-HMOs), ngokuvamile izinsizakalo zokunakekelwa kwempilo yezezimali ngezinga lokuxoxisana, inani lokukhokhelwa kwabahlinzeki bezempilo.
Abamukeli bokunakekela nabanakekeli
- Abantu abangaba yizigidi ezingu-7.6 e-US badinga uhlobo oluthile lokunakekelwa kwezempilo ekhaya.
- Abahlinzeki bezempilo bezempilo abangaphezu kuka-20 000 bakhona namuhla.
- Cishe izingxenye ezimbili kwezintathu (amaphesenti angu-63,8) abamukeli bempilo yekhaya ngabesifazane.
- Ngaphezu kwezingxenye ezimbili kwezintathu (amaphesenti angu-69,1) abamukeli bezempilo ekhaya bangaphezu kweminyaka engama-65.
- Izimo ezidinga ukunakekelwa kwempilo yasemakhaya kaningi zibandakanya isifo sikashukela, ukwehluleka kwenhliziyo, isilonda esingapheli esikhumbeni, i-osteoarthritis, nomfutho wegazi ophezulu.
- Imindeni engaphezu kweyodwa kwabayisithathu base-US (abalinganiselwa abangaba ngu-48.9 million abaneminyaka engama-18) bangabanakekeli abangahlelekile kumuntu oneminyaka engama-18 ubudala, enezigidi eziyizigidi ezingu-16.8 ezinakekela izingane noma zombili izingane kanye nabantu abadala, ngokulinganiselwa kwezigidi ezingama-65.7 ezizinakekeli ngabanye .
- Abanakekeli abangamaphesenti angu-63 bashadile futhi / noma bahlala nomlingani, kanti izingxenye ezimbili kwezintathu (66%) zingabesifazane.
- Ingxenye eyodwa kwezintathu (ukunakekelwa kwamaphesenti angu-34) ukunakekela abantu ababili noma ngaphezulu, ngamaphesenti angu-86 anikezela ukunakekelwa kwesihlobo-okungaphezu kweyesithathu kokunakekela umzali nomunye kwabayisikhombisa (amaphesenti angu-14) abanakekela ingane yabo.
- Umnakekeli ojwayelekile ngumama oneminyaka engu-48 ubudala onika amahora angaphezu kwama-20 ukunakekelwa ngesonto ngalinye.
Abanakekeli abakhokhelwayo
Abanakekeli abahlelekile bafaka abaqeqeshiwe kanye nama-paraprofessionals ahlawuliswa ukuhlinzeka ngezinsizakalo zezempilo ekhaya kanye nezinsizakalo zokunakekela abantu.
- Abantu abangu-958,000 baqashwe ejensi lokunakekelwa kwezempilo ngo-2008.
- izinombolo ezinkulu zabasebenzi / ama-FTEs aids ukunakekelwa ekhaya kanye RNs.
- kusukela ngo-1993 kuya ku-2008, ukunakekelwa kwekhaya emsebenzini kwakhula isilinganiso se-5.4% ngonyaka (510,000 kuya ku-961,400).
Ukufaneleka kokunakekelwa
Ukunakekelwa kwekhaya kuyinkonzo ekhokhela izindleko zabantu abahlala behlala esibhedlela futhi kulabo abathi, ngenxa yokukhubazeka okusebenzayo noma okungaqondakali, abakwazi ukuzizinakekela. Ukunakekelwa kwekhaya kuqinisa futhi kunakekele ukunakekelwa okuhlinzekwa amalungu omndeni nabangane futhi kulondoloze isithunzi nokuzimela. Iziguli ezazithola izinsizakalo zokunakekelwa ekhaya kwakungenasiphelo esincane sokubhaliswa esibhedlela.
Izinselelo
Ngo-2011 imboni yabhekana nenselele entsha. Abahlomuli be-Medicare kudingeka babone udokotela izinsuku ezingu-90 ngaphambi kwezinsuku ezingu-30 ngemuva kokuqala izinsizakalo zezempilo zasekhaya ukuze i-ejensi yezempilo yasekhaya ibuyiselwe. Ngaphansi komthetho omdala, udokotela angase anikeze ukunakekelwa kwempilo ekhaya ekhaya iziguli ukuze zithole izinsizakalo, kodwa udokotela kwakungadingeki ukuba abone isiguli ukwenza leso sinqumo.
Ngaphansi komthetho omusha, odokotela kufanele bagcwalise ifomu ukuqinisekisa ukuthi bona noma omunye umhlinzeki wezempilo njengomhlengikazi wayebone isiguli ngenjongo ethile yokunquma isidingo sesiguli sokunakekela ekhaya. Lokhu kungaphezu kwemisebenzi yamanje kadokotela yokubeka ukunakekelwa kwezempilo ekhaya futhi isayine ohlelweni lokunakekelwa, okuyinto evame ukuthuthukiswa yi-ejensi yezempilo ekhaya.