Inotengeswa Nechirongwa Chekutarisira Inozarura Mikana yeVashmese-Vakapa Services
Murwere Anodzivirirwa uye Anogadziriswa Kuchengetedza Mutemo (PPACA)-zvichida inonyatsozivikanwa seObamacare -murairo wakaponeswa 30-pamwe nemavhoti ekudzibvisa kana kubhadharisa, wakatsigirwa sebumbiro remitemo neDare Repamusorosoro reUnited States, uye akatungamira pakuzara kushanda mu chiso chevanhu vakawanda vanoremekedzwa pachena.
Zvinenge zvisingatauri ndezvakakwanisa kuita mikana yePACACA inofanira kuchinja zuva rega rega maitiro emagariro evanhu vemunharaunda.
Obamacare uye Community Pharmacist
VaAmerican Pharmacists Association (APhA) uye vashandi veNational Community Pharmacists Association (NCPA) vakaratidza kuti Obamacare akadzokorora sei hutano hwehutano hwevanhu veAmerica vanonyanya kufambira mberi mune zvehutano. Vakatarisawo zvikamu izvo zvinoda kujekeswa kana kuchinjwa kuti zvibvumira varimi kuti vabatsire zvakakwana sezvinobvira kuwedzera kukwanisa kwevarwere kutarisira, kuderedza mari yekurapa uye kudzivirira chirwere.
Kuvhura Medicare Chikamu D Donut Hole
Panenge pakarepo, PPACA yakabudisa vazhinji vanozvimiririra vomunharaunda vanozvimirira kubva mumutemo weMedricare vachida kuti vatengesi vose vezvigadzirwa zvechiremba zvinogara kwenguva refu, prosthetics, orthotics uye zvinhu (DMEPOS) kuti vazobvumirwa. NCPA Mutevedzeri Wachigaro weHurumende, John Coster, Ph.D., RP, vakati izvi zvakabvumira maparamendi anokwana pasi pe5 kubva muzana yemari kubva kuDMEPOS yekutsvaga kuti varambe vachichingana nevarwere vachitsvaga zvido zvehutano pasina hutori hwekutevedzera mitemo yepamusoro.
Coster akatiwo kupedzisira kupera kwechirongwa chechirongwa chechirongwa chemishonga cheMedarered D Dzakabatsiri chakatanga pasi pePACACA muna 2011 chakafamba zvakanaka.
"Hauna kupa matambudziko akawanda atakanzwa nezvazvo," akadaro.
"Vanachimishonga vanoendesa mberi zvikwereti kune varwere vari munharaunda, uye zvirongwa zvinofanira kuzvidzosera mumazuva gumi nemasere kubva kugamuchira zvido.
Zvirongwa izvi zviri kubhadhara panguva yakareba. Tichafanira kuona kana izvozvo zvichiri kuenderera mberi apo gomba rekushandisa rinopedza zvachose muna 2014. "
Mudondo WeMedicaid
Izvo PPACA inopawo sarudzo yekuwedzera kufanirwa kweMedicaid kuvanhu vose vari mumhuri dzine mari yegore negore kusvika ku13 muzana yehurumende yehurombo. Vatongi vashomanana vakati havangagamuchiri rubatsiro rwehurumende kuti ruite saizvozvo, nhamba huru yakatora kurindira-uye-kuona nzira, uye chirongwa chiduku che nhamba yekuwedzera kuverengera kweMedicaid.
"Ndeapi mafaramadzi anoona neMedicaid achange avimba zvakakwana pane zvavari kuita," akadaro APhA Vachigaro Vachigaro Mukuru wehurumende Brian Gallagher, RPh, JD. "Asi kunyange mune zvinyorwa zvinosarudza kusavhara vamwe varwere veMedicaid, zvichiri kuitika nehurongwa hweMedicaid huchagadzirisa kuti chii chinoshandiswa mutengo uye chii chakanaka chekubhadhara mari inofanira kuitwa."
Coster, ane NCPA, akaratidzawo kudikanwa kwemasangano eDenclad for Medicare & Medicaid Services mitemo inochengetedza mutengo wakarurama uye kubvunzwa kwevhutu kune vatongi vanogadzira pharmacy kubhadhara pane iyo data.
"Chimwe chekuzvikudza kune zvaiitwa kwatiri ndechekuwana mitemo muPACACA yezvemishonga inobatsira vatungamiri vekushambadzira, kunyanya pamitengo yekugadzirisa nzvimbo.
Kuwana nhamba idzodzo kuchatibatsira kuti tive nemafungiro emari yemari yemishonga inoponesa varwere nevatori. "
Alternative Murefu Kutarisira Models uye Mishonga Therapy Management (MTM)
Iko gungwa chaiyo kuchinja kubva kuPACACA inogona kuuya nekutangwa kweA Accountable Care Organisations, mishonga yezvokurapa uye mamwe maitiro ezvimwe zvirwere zvevarwere. CMS yakasimbisa iyo Centre for Medicare & Medicaid Innovations muna 2010 uye yakatovapa zvipo zvakasiyana-siyana uye zvibvumirano zvekushandisa zvirongwa zvakadaro.
Kusarudzira huwandu hwakazara hweAACO huri kunze kwehuwandu hwenyaya ino, asi APhA Vachigaro Vachigaro Vakuru vezveMasangano anonzi Anne Burns, BSPharm, vakati, "Tiri kuona mukana wemakemhizha kuti vabatanidzwe mune izvi zvinotarisirwa kutarisirwa.
Vanachiremba vari kuramba vachinyatsoziva kuti kusanganisira vanachiremba mune vehutano hwehutano hunokosha pamabasa akadai sekugadzirisa zvinorapwa mishonga yemishonga, kupa mishonga yevarwere, uye kuderedza mari yezvokurapa uye kudzivirira zvinetso nehutachiona hwehutachiona. "
Akawedzera kuti "Kushandisa zvivako zvekubhadhara kunotsigira kuve nekubatanidzwa kwevemasimusi mune izvi zvinoratidzika ndiko kunonyanya kukoshesa kweAAPA iye zvino.Use hutano hunokoshesa zvinyorwa zvinyorwa kuti kudzivirira kuva chinhu chikuru chekuvandudza zvirwere zvehutano hwevarwere."
Uyewo kuongorora kuve nechokwadi kuti vanachiremba vanogona kugamuchira kubhadharwa kwekushanda mukati meAACO kana imwe sangano rekuchengetedza, sangano reNational Association of Chain Drug Stores rakamanikidza Congress kudarika S. 274, Mutemo weMedication Therapy Management Empowerment Act, uye HR 891, Medication Therapy Management Benefits Act. Vose vari kutarisa kubhadhara mishonga kuti vape maMTM mabasa, asi mabhiriro anomira mikana miduku kusvikira Congress itsva igere uye zvirevo zvadzo zvakare muna 2013.
Kuzobatana nehuwandu hwemunharaunda kuchava chinhu chinokosha kumasvomemese emunharaunda, maererano naBurns. "ACOs uye mishonga yemishonga yezvokurapa inowanikwa munzvimbo yepamunharaunda kuitira kuti vanachiremba vanoda kuziva zviri kuitika munharaunda yavo. Kunze kwemasangano ezvemishonga ehurumende, vanachiremba vemunharaunda, masangano emagariro evanhu, uye vatengi vanonyanya kukosha kuti vazive mikana iri kunze uko, "akadaro.
Semuenzaniso wekuti masharamese anototanga kupa sei hutano hwakanaka hwekurapa, semuenzaniso, APhA inopa chikamu chose chebasa rekuMTM.