Umthetho Wokunakekelwa Onganakekelwayo Uvula Amathuba Ezinsizakalo Ezihlinzekwa Ngum Pharmik
Umthetho Wokuvikelwa Kweziguli kanye Nokunakekelwa Okunakekelwa Kwezimali (PPACA)-mhlawumbe owaziwa ngokuthi yi- Obamacare -ngumthetho osinda kuma-30-plus amavoti okuwususa noma ukuwususa imali, uye waqiniswa njengomthethosisekelo yiNkantolo Ephakeme yase-United States, futhi waqhutshwa ngokugcwele ubuso obunqatshelwe umphakathi.
Cishe kungabonakali ukuthi ama-PPACA amaningi angase akwazi ukushintsha ukujwayela kwansuku zonke kumakhemikhali omphakathi.
I-Obamacare ne-Pharmacy yomphakathi
I-American Pharmacists Association (APhA) kanye nabaphathi beNational Community Pharmacists Association (NCPA) baye baqokomisa ukuthi u-Obamacare uphinde wavuselela kanjani isimo sokunakekelwa kwezempilo kubantu abaqeqeshiwe bezokwelapha e-America. Baye baqaphela ukuthi yiziphi izinhlinzeko okudingeka zicaciswe noma zishintshwe ukuze kuvunyelwe abakwa-pharmacy ukuba banikele ngokugcwele ngangokunokwenzeka ekwandiseni ukufinyelela kweziguli ekunakekeleni, ukunciphisa izindleko zemithi nokuvimbela ukugula.
Ukuvala i-Medicare Part D Donut Hole
Ngokushesha, i-PPACA yaxoshwa abaningi abakhemisi bomphakathi abazimele ezivela emthethweni we-Medicare odinga bonke abathengisi bemishini yezokwelapha ehlala njalo, izidakamizwa, ama-orthotics kanye nempahla (DMEPOS) ukuze bavunyelwe. I-NCPA I-Vice President of the Government of Commerce uJohn Coster, Ph.D., u-RPh, uthe lokhu kuvumela ukuthi ama-pharmacy akhiphe ngaphansi kwamaphesenti angama-5 emali evela ekuthengisweni kwe-DMEPOS ukuze aqhubeke nokuhlangana nezidingo zezempilo ezibucayi ngaphandle kokufaka izindleko zokuhambisana nemigomo yokuphindaphindiwe.
UCoster uthe ukuvalwa kancane kancane kwegciwane lokutholakala kwezidakamizwa ze-Medicare Part D abazuzi abaqalayo ngaphansi kwe-PPACA ngo-2011 uye waqhubeka kahle.
"Akakaze alethe izinkinga eziningi esizizwile," esho.
"Amakhemikhali athola izaphulelo ezigodini emgodini we-donut, futhi izinhlelo kumele zibuyisele emuva ezinsukwini ezingu-14 zokuthola izimangalo.
Amalungiselelo akhokha ngesikhathi. Kuzodingeka sibone ukuthi lokho kuqhubeka yini uma imbobo yokuxhuma ivaliwe ngokuphelele ngo-2014. "
Isigubhu seMedicaid
I-PPACA inikezela futhi ithuba lokukhulisa ukuxilongwa kwezidakamizwa kubo bonke abantu emakhaya abanemali engenayo yonyaka kuze kufike kumaphesenti angu-133 wezinga lobuphofu lombuso. Ababusi abambalwa bathi ngeke bakwamukele izinsizakalo zombuso ukuze benze kanjalo, inamba ekhudlwana ithathe indlela yokulinda nokubona, futhi uhlelo lwezinombolo ezincane ukwandisa ukubhaliswa kwabakwaMedicaid.
"Abaphimisi ababona nge-Medicaid bazoxhomeke ngokuphelele kulokho abakwenzayo," kusho i-APhA Iphini likaMongameli oPhethe likaHulumeni uBrian Gallagher, RPh, JD. "Kodwa ngisho nasezikhulwini ezithatha isinqumo sokungafihli iziguli eziningi ze-Medicaid, kusasele izinkinga nokuthi izinhlelo zeMedicaid zizonquma kanjani izindleko zomkhiqizo nokuthi yiyiphi imali edingekayo yokunikezela okudingeka yenziwe."
UCoster, no-NCPA, uphinde wabonisa isidingo sama-ironclad Amasevisi we-Medicare & Medicaid Services imithetho eqinisekisa ukuthi amanani anembile kanye nokubika kwevolumu kulabo abalawulayo abenza izinkokhelo zama-pharmacy kulawo datha.
"Enye yezinto eziziqhenya ngokuziqhenya ngathi kwakungenisa izindinganiso ku-PPACA yezinzuzo zokusebenza kwemithi ekhemisi, ikakhulukazi kumazinga okufaka esikhundleni sama generic.
Ukuthola lezo zinombolo kuzosisiza ukuba senze icala lethu ngokuthi abakwa-pharmacy bangakanani abagcina iziguli nabakhokhi. "
Amanye amaModeli Wokunakekelwa Kwamaphesenti Nokuphathwa Kwemithi (MTM)
Ukuguquka kwangempela kolwandle okuvela ku-PPACA cishe kuzokuza nokuqaliswa kwezinhlangano zokunakekela ezizimele, izindlu zezokwelapha nezinye izindlela zokunakekelwa kweziguli. I-CMS yakha isikhungo sayo seMediare & Medicaid Innovations ngo-2010 futhi sesivele inikeze izibonelelo ezihlukahlukene nezinkontileka zokuqalisa izinhlelo ezinjalo.
Ukuchaza ukugcwele kwe-ACO kungaphezu kwalesi sihloko, kodwa i-APhA Iphini likaMongameli oPhethe loMnyango wezengcweti u-Anne Burns, uBSPharm, uthi, "Sibheka ithuba labamakhemisi ukuthi bahlanganyele kulezi zibonelo zokunakekelwa.
Odokotela bayaqhubeka beqaphela ukuthi kufaka phakathi amakhemikhali eqenjini lezokunakekelwa kwezempilo kubalulekile emisebenzini efana nokuphatha imithi yokwelapha eyinkimbinkimbi, ukuhlinzeka ngemfundo yesiguli, nokunciphisa izindleko zezokwelapha nokuvimbela izinkinga nge-drug therapy. "
Uthe: "Ukusebenzisa izakhiwo zokukhokha ukusekela ukubandakanyeka kwamaphilisi kulezi zinkhulumo kuhloswe ngokuyinhloko kwe-APHA njengamanje. Wonke amanani amaphuzu ezincwadi zezempilo ekuvimbeleni abe yisihluthulelo sokwenza ngcono imiphumela yezempilo yeziguli."
Ukuqaphela ukuthi ukuqinisekisa ukuthi abakwa-pharmacy bangathola ukubuyiswa kokusebenza ngaphakathi kwe-ACO noma enye inhlangano yokunakekelwa kokubambisana, i-National Association of Chain Drug Stores iye yacindezela iCongress ukuba idlule iSiya 274, uMthetho weMithi yokuPhathwa kweMithi yokuPhathwa kweMithi, no-HR 891, i-Medication Therapy Management Act Benefits. Bobabili ikheli likhokhela abakwa-pharmacy ukuhlinzeka ngamasevisi e-MTM, kodwa izindleko zimisa amathuba amancane kuze kube yilapho iCongress entsha ihlezi futhi iziphakamiso ziphinde zithunyelwe ngo-2013.
Ukubandakanyeka ezingeni lendawo kuzoba yisisekelo samakhemikhali omphakathi, ngokusho kukaBurns. "I-ACO kanye nemikhuba yasekhaya yezokwelapha zakhiwa ezingeni lendawo ukuze abakwa-pharmacy badinga ukuqaphela okwenzeka emiphakathini yabo. Ukuphuma kwamanye amazwe ukuchaza izinhlangano ze-ekhemisi, odokotela bendawo, izinhlangano zomphakathi kanye nabakhokhela kubalulekile ekufundeni ukuthi yimaphi amathuba akhona, "esho.
Njengesibonelo sendlela abakwa-pharmacy base behlinzekela ngayo ukunakekelwa kweziguli ezintsha, isibonelo, i-APhA idlulisela sonke isigaba sewebhusayithi yayo kuMTM.