Ukuthuthukisa Ukuphila Kweziguli Ze-Medicare Ngezifo Zezinso Manje

Ibhalwe ngu umhleli

Izinhlelo zihlose ukunciphisa ukuqhubeka kwesifo sezinso futhi zandise ukufinyelela ku-dialysis yasekhaya kanye nokufakelwa kwezinso.

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I-DaVita Integrated Kidney Care (DaVita IKC) - kanye nodokotela bezinso abacishe babe yi-1,000, abahlinzeki bokufakelwa kabusha, abahlinzeki besibhedlela abagulela ukufa kanye nabelaphi abasezingeni eliphakeme - namuhla bamemezele ukwethulwa kwezinhlelo zokunakekelwa kwe-value-based eziyi-11 kulo lonke elase-US, okulindeleke ukuthi zifinyelele izinso ezilinganiselwa ku-25,000. iziguli. Izinhloso zalezi zinhlelo ukusiza ukubambezela ukuqhubeka kwesifo sezinso esingalapheki (CKD) nokusiza iziguli eziningi ezinokwehluleka kwezinso ukufinyelela ukufakelwa izinso kanye ne-dialysis emakhaya azo.     

Lezi zinhlelo ziyingxenye yemodeli entsha kahulumeni Yokuzikhethela Kokunakekelwa Kwezinso (i-KCC)—ukubonisa ukunakekelwa okusekelwe enanini okuqale ngo-Jan. 1, 2022, futhi kuzodonsa iminyaka emihlanu yokusebenza. I-DaVita IKC kanye nozakwethu babamba iqhaza kunketho ye-Comprehensive Kidney Care Contracting (CKCC) ngaphakathi kwe-KCC.

Ngokufanayo nemibukiso kahulumeni yokunakekelwa okusekelwe emvelweni, i-CKCC ivumela izikhungo ze-dialysis, i-nephrologists nabanye abahlinzeki bezempilo ukuthi bakhe izinhlangano zokunakekela ezigxile ezinso ukuze zilawule ukunakekelwa kweziguli ze-Medicare. Okwenza ukuboniswa kwe-CKCC kuhluke ukuthi kuthuthukisa izikhuthazo zezezimali zokuphatha ukunakekelwa kweziguli ze-Medicare ezine-CKD izigaba 4 no-5, ukubambezela ukuqala kwe-dialysis kanye nokugqugquzela ukufakelwa kwezinso.

I-CKD ithinta cishe oyedwa kwabangu-1 (izigidi ezingu-7) abantu abadala base-US. Ngeshwa, abantu abaningi abane-CKD abazi ukuthi ukusebenza kwezinso zabo kuyehla. Njengamanje, kulinganiselwa ukuthi amaphesenti angama-37 abantu okutholwe ukuthi banokwehluleka kwezinso "ukuphahlazeka" ku-dialysis-ukuqala ukwelashwa ngaphandle kwesixwayiso esimweni esiphuthumayo.[50] Ukuphahlazeka akubangeli nje ukucindezeleka ngokomzimba nangokomzwelo ezigulini kodwa futhi kubiza, ngokwesilinganiso, i-$2 eyengeziwe ngesiguli ngasinye onyakeni wokuqala wokwelashwa kwe-dialysis.

Okunye, izinhlelo ezifanayo zokunakekelwa okusekelwe enanini zisebenze kahle ikakhulukazi kubantu abanesidingo esikhulu, ezibiza kakhulu, njengalezo ezine-CKD kanye nesifo sezinso sokuphela kwesigaba (ESKD). Izinhlelo ezinjalo zinika amandla iziguli, odokotela namathimba okunakekela ukusiza ukubambezela ukuqhubeka kwe-CKD ngokulawula kangcono izici eziyingozi njengesifo sikashukela nomfutho wegazi ophakeme—izimbangela ezimbili eziphambili ze-ESKD.

Ezigulini ezisohlelweni lwe-CKCC, i-DaVita IKC kanye nabalingani bayo bagxile ekuxhumaniseni kangcono izidingo zabo zokunakekelwa kwezinso nezingezona zezinso, kanye nokuthuthukisa ukungenelela ukuze zibasize baphile futhi baphume esibhedlela. Eqinisweni, ukunciphisa ukulaliswa esibhedlela akugcini nje ngokunikeza lezi ziguli izikhathi ezengeziwe zisekhaya zenza ezikuthandayo kodwa futhi kungehlisa inani lezindleko zokunakekelwa—uphawu lwanoma yiluphi uhlelo lokunakekela olusekelwe enanini oluyimpumelelo.

Ngenxa yokuthi lezi zinhlelo zizofinyelela inani elihlukahlukene leziguli ze-Medicare ezindaweni eziningi zasemadolobheni, i-DaVita IKC iphinde ibone ithuba lokuqhubeka nokusiza ukukhiqiza ukulingana kwezempilo okukhulu ngaphakathi kokufakelwa kanye nokunakekelwa kwezinso ngokubanzi.

Ngokwethulwa kwezinhlelo zayo ze-CKCC, i-DaVita IKC ilindele ukuphinda kabili inani leziguli ezithola ukunakekelwa kwezinso okudidiyelwe onyakeni wokuqala wokusebenza kuphela. Ngokungeziwe ezinhlelweni zayo eziningi zokunakekelwa okusekelwe ukubaluleka nezinhlelo zezempilo kulo lonke elase-US, lokhu kusiza ukuthuthukisa umgomo we-DaVita IKC wokuletha izinzuzo zokunakekelwa kwezinso okudidiyelwe kuzo zonke iziguli.

Ukubamba iqhaza kuka-DaVita ezinhlelweni zokunakekelwa okusekelwe entweni kugcizelela ukuzibophezela kwayo kukonke ukuhlanganisa nokwenza ngcono ngenkuthalo ulwazi nokunakekelwa kuzo zonke izigaba kanye nokuhlela uhambo lokunakekelwa kwezinso lwesiguli. Njengamanje, i-DaVita ilawula iziguli ezisuka ku-CKD ziye ku-ESKD ngokufakelwa kabusha, futhi ikwenza lokho kungakhathaliseki ukuthi isiguli sicosha umshini ekhaya, esibhedlela noma kwesinye sezikhungo zaso zokulaliswa ngaphandle.

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