Iro Healthcare Capitation Payment Systems Work

Kubhadharwa neMurwere

Kufuridzirwa kunoreva maitiro ehutano hwehutano hwekubhadhara . Mutevedzeri wekutapa, mutapi wehutano kana chipatara chimwe nechimwe inobhadharwa nemubhizimisi (kana mumwe mubhadhari) mari yakatarwa pamurwere panguva yakapiwa nguva. Izwi rokuti capitation rinobva kune rechiLatini shoko re musoro, caput . Tsanangudzo yekutengesa ndeyokuti kuverengwa kwemusoro kunotorwa uye kubhadhara kwakavakirwa kubva pachiverengero ichocho pasina kutarisira kushandiswa kwechokwadi kwehutano hwehutano.

Capitation System Example

Chimiro chemufananidzo wekutsvaga chaizova mubhadhadziro kana mubhadharo uyo aizotaurirana kubhadhara chiremba $ 500 pagore nemumwe munhu muboka. Kune vanhu 1 000, iyo inshuwarheni yaizobhadhara chiremba $ 500 000 uye chiremba aizotarisirwa kupa zvese zvinodiwa kune avo 1 000 vanhu vakasiyana.

Kana mumwe munhu mumwechete (murwere) akashandisa $ 2,000 yehutano hwehutano hwehutano, ipapo chiremba uyo aizoguma achirasikirwa ne $ 1,500 pamurwere uyu. Kune rumwe rutivi, kana mumwe murwere chaiye akashandisa mari ye $ 10 chete yehutano hwehutano, ipapo chiremba aizoita mari ye $ 490 pamurwere uyu. Zvechokwadi, mumutowo wakadaro, chinangwa chikuru chechiremba ndechekuchengeta zvakawanda zveyo iyo inotora mari yakawanda sezvinobvira.

Kusiyana nekunyorera hurumende kungava hutano hwehutano apo anopa mubhadharo ari kubhadhara mari yega yega yebasa rakapiwa. Kana murwere aida CT scan , iyo inshuwarheni yaizobhadhara CT scan, isina chokuita nehuwandu humwe humwe huripo kana mari yekubhadhara inofanira kuitwa.

Kubatsirwa kweNzvimbo yekudzivirira

Kubatsira kukuru kwekubhadhara mari yekutsvaga kwechiremba kana kuti inshurenzi ndiko kuderedza mari yekugadzirisa mabhuku . Chiremba haafaniri kubhadhara vashandi vakakura vevashandi vanobhadhara, uyewo haafaniri kumirira kuti apiwe mari yehupi hupi hupi hupi huripo. Chiremba chaiwo chechiremba kutarisira varwere vake chinogona kuderera.

Kubatsirwa kwebhaisivha kana kubhadhara ndeyekuti urongwa hunoderedza kukurudzira kupa hutano hwakanyanya kupfuura zvinodiwa. Izvi zvinoderedza izvo zvavanofanira kubhadhara mupiro, pamwe nekuderedza kudhura kwavo mari.

Chimwe chekubatsira ndechokuti murwere haakwanisi kupiwa rubatsiro rwusingadikanwi rwusingave ruchakwanisa kuvandudza hutano hwavo kana mamiriro asi huchawedzera mari yavo yekutarisira hutano kana vaifanira kubhadhara mari yekubhadhara . Kunyanya kutarisirwa hakusi nguva dzose kutarisirwa zvakanaka.

Zvinyorwa zveChechi yeKubata

Zvinokuvadza ndezvokuti chiremba anotanga kuita zvisarudzo pamusoro pekutarisira kwaanozoita kana kuti haazopi nekupa nokuti achaita mari yakawanda kuburikidza nekupa kutarisira kwakanyanya, chimiro chekuchengetedza kwehutano . Kunyanya kutarisirwa kunoitwa nachiremba kumurwere, iyo inowedzera kurapa kwehutano wehutano ichave. Zvisinei, chiremba anobhadhara zvakafanana zvachose, pasinei nebasa rakawanda kana ridiki raanoita kune murwere. Nokudaro, chirongwa ichi chinosanganisira zvakagadzirirwa-chikonzero chokuti chiremba aone varwere vakawanda sezvinobvira, pane kungotarisa zvakanyanya kune mumwe murwere.