(Austin) \u2013 H\u1ed9i \u0111\u1ed3ng qu\u1ea3n l\u00fd Central Health \u0111\u00e3 b\u1ecf phi\u1ebfu v\u00e0o th\u1ee9 T\u01b0, ng\u00e0y 12 th\u00e1ng 9, \u0111\u1ec3 h\u1ea1n ch\u1ebf ngu\u1ed3n t\u00e0i tr\u1ee3 cho Sendero Health Plans, T\u1ed5 ch\u1ee9c b\u1ea3o tr\u00ec s\u1ee9c kh\u1ecfe (HMO) phi l\u1ee3i nhu\u1eadn c\u1ee7a t\u1ed5 ch\u1ee9c n\u00e0y, do nh\u1eefng th\u00e1ch th\u1ee9c t\u00e0i ch\u00ednh \u0111ang di\u1ec5n ra v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng ng\u00e0y c\u00e0ng tr\u1ea7m tr\u1ecdng h\u01a1n.<\/p>\n
\u0110\u01b0\u1ee3c th\u00e0nh l\u1eadp n\u0103m 2012 b\u1edfi Central Health nh\u1eb1m cung c\u1ea5p b\u1ea3o hi\u1ec3m y t\u1ebf cho ng\u01b0\u1eddi c\u00f3 thu nh\u1eadp th\u1ea5p. S\u1ea3n ph\u1ea9m b\u1ea3o hi\u1ec3m IdealCare c\u1ee7a Sendero hi\u1ec7n c\u00f3 kho\u1ea3ng 24.000 th\u00e0nh vi\u00ean. B\u1ea3o hi\u1ec3m y t\u1ebf c\u1ee7a h\u1ecd s\u1ebd c\u00f3 hi\u1ec7u l\u1ef1c \u0111\u1ebfn h\u1ebft n\u0103m 2018. Trong th\u1eddi gian \u0111\u0103ng k\u00fd m\u1edf s\u1eafp t\u1edbi c\u1ee7a \u0110\u1ea1o lu\u1eadt Ch\u0103m s\u00f3c S\u1ee9c kh\u1ecfe H\u1ee3p t\u00fai ti\u1ec1n (ACA), c\u00e1c th\u00e0nh vi\u00ean s\u1ebd c\u00f3 c\u01a1 h\u1ed9i l\u1ef1a ch\u1ecdn g\u00f3i b\u1ea3o hi\u1ec3m \u01b0a th\u00edch cho n\u0103m 2019. L\u00e0 m\u1ed9t b\u01b0\u1edbc chuy\u1ec3n ti\u1ebfp, Sendero \u0111ang xem x\u00e9t cung c\u1ea5p g\u00f3i IdealCare Bronze cho n\u0103m 2019.<\/p>\n
Trong cu\u1ed9c h\u1ecdp h\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb v\u00e0o th\u1ee9 T\u01b0 v\u1ec1 ng\u00e2n s\u00e1ch v\u00e0 thu\u1ebf su\u1ea5t n\u0103m t\u00e0i ch\u00ednh (FY) 2019, v\u00e0 sau qu\u00e1 tr\u00ecnh ph\u00e2n t\u00edch s\u00e2u r\u1ed9ng c\u00f9ng nhi\u1ec1u gi\u1edd th\u1ea3o lu\u1eadn trong v\u00e0i th\u00e1ng qua, \u0111a s\u1ed1 th\u00e0nh vi\u00ean h\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb Central Health \u0111\u00e3 quy\u1ebft \u0111\u1ecbnh r\u1eb1ng vi\u1ec7c h\u1ea1n ch\u1ebf r\u1ee7i ro trong t\u01b0\u01a1ng lai l\u00e0 v\u00ec l\u1ee3i \u00edch t\u1ed1t nh\u1ea5t cho s\u1ee9 m\u1ec7nh c\u1ee7a c\u00f4ng ty, cho ph\u00e9p thu h\u1eb9p ho\u1ea1t \u0111\u1ed9ng c\u1ee7a Sendero m\u1ed9t c\u00e1ch c\u00f3 tr\u00e1ch nhi\u1ec7m.<\/p>\n
M\u1eb7c d\u00f9 ph\u1ea3n \u0111\u1ed1i quy\u1ebft \u0111\u1ecbnh \u0111\u00f3ng c\u1eeda Sendero, Ch\u1ee7 t\u1ecbch H\u1ed9i \u0111\u1ed3ng Qu\u1ea3n tr\u1ecb, Ti\u1ebfn s\u0129 Guadalupe Zamora, th\u1eeba nh\u1eadn nh\u1eefng kh\u00f3 kh\u0103n trong quy\u1ebft \u0111\u1ecbnh c\u1ee7a h\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb. "T\u00f4i \u0111\u00e3 y\u00eau c\u1ea7u c\u00e1c b\u1ea1n \u0111\u1ebfn v\u1edbi m\u1ed9t t\u00e2m th\u1ebf c\u1edfi m\u1edf", Ti\u1ebfn s\u0129 Zamora n\u00f3i. "Ch\u00fang t\u00f4i \u0111\u00e3 ph\u00e2n t\u00edch c\u00e1c con s\u1ed1 v\u00e0 c\u00f3 nh\u1eefng cu\u1ed9c th\u1ea3o lu\u1eadn d\u00e0i, \u0111\u00f4i khi \u0111\u1ea7y c\u1ea3m x\u00fac v\u1ec1 t\u01b0\u01a1ng lai c\u1ee7a Sendero. Cu\u1ed1i c\u00f9ng, t\u00f4i \u1ee7ng h\u1ed9 nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 b\u1ecf phi\u1ebfu gi\u1ea3i th\u1ec3 c\u00f4ng ty v\u00e0 t\u00f4i bi\u1ebft t\u1ea5t c\u1ea3 c\u00e1c b\u1ea1n \u0111\u1ec1u \u0111ang \u0111au l\u00f2ng khi ch\u00fang ta \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh v\u00f4 c\u00f9ng kh\u00f3 kh\u0103n n\u00e0y."<\/p>\n
Th\u00e0nh vi\u00ean H\u1ed9i \u0111\u1ed3ng Qu\u1ea3n tr\u1ecb Katrina Daniel, c\u1ef1u Ch\u1ee7 t\u1ecbch H\u1ed9i \u0111\u1ed3ng Qu\u1ea3n tr\u1ecb Central Health, \u0111\u00e3 \u0111\u1ec1 xu\u1ea5t t\u0103ng kho\u1ea3n \u0111\u1ea7u t\u01b0 c\u1ee7a Central Health v\u00e0o Sendero th\u00eam $4 tri\u1ec7u \u0111\u00f4 la trong n\u0103m t\u00e0i ch\u00ednh 2019, n\u00e2ng t\u1ed5ng s\u1ed1 ti\u1ec1n \u0111\u1ea7u t\u01b0 l\u00ean $24 tri\u1ec7u \u0111\u00f4 la. Kho\u1ea3n \u0111\u1ea7u t\u01b0 n\u00e0y s\u1ebd t\u00e0i tr\u1ee3 cho chi ph\u00ed v\u1ed1n v\u00e0 c\u00e1c chi ph\u00ed ho\u1ea1t \u0111\u1ed9ng li\u00ean quan v\u1edbi \u0111i\u1ec1u ki\u1ec7n Sendero ph\u1ea3i ng\u1eebng ho\u1ea1t \u0111\u1ed9ng trong v\u00f2ng hai n\u0103m t\u1edbi.<\/p>\n
\u201cT\u00f4i \u0111\u00e3 \u1ee7ng h\u1ed9 Sendero t\u1eeb l\u00e2u v\u00e0 tin r\u1eb1ng ch\u00fang t\u00f4i \u0111\u1ea7u t\u01b0 v\u00e0o c\u00f4ng ty v\u00ec t\u1ea5t c\u1ea3 nh\u1eefng l\u00fd do ch\u00ednh \u0111\u00e1ng,\u201d Daniel n\u00f3i. \u201cSendero \u0111\u00e3 ph\u1ea3i \u0111\u1ed1i m\u1eb7t v\u1edbi nhi\u1ec1u th\u00e1ch th\u1ee9c trong nh\u1eefng n\u0103m qua, bao g\u1ed3m qu\u00e1 nhi\u1ec1u \u0111\u1ed1i th\u1ee7 c\u1ea1nh tranh tr\u00ean th\u1ecb tr\u01b0\u1eddng l\u00fac ban \u0111\u1ea7u, v\u00e0 s\u1ef1 b\u1ea5t \u1ed5n xung quanh \u0110\u1ea1o lu\u1eadt Ch\u0103m s\u00f3c Gi\u00e1 c\u1ea3 ph\u1ea3i ch\u0103ng (ACA) hi\u1ec7n nay. Ch\u00fang t\u00f4i kh\u00f4ng thua l\u1ed7 \u2013 ch\u00fang t\u00f4i \u0111\u00e3 \u0111\u1ea7u t\u01b0 v\u00e0o ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe c\u1ee7a m\u1ecdi ng\u01b0\u1eddi. Nh\u01b0ng t\u00f4i tin r\u1eb1ng ch\u00fang ta c\u1ea7n m\u1ed9t h\u01b0\u1edbng \u0111i m\u1edbi cho Central Health, mang l\u1ea1i s\u1ef1 \u1ed5n \u0111\u1ecbnh v\u00e0 ch\u1eafc ch\u1eafn h\u01a1n v\u1ec1 m\u1eb7t t\u00e0i ch\u00ednh.\u201d<\/p>\n
V\u1edbi t\u1ef7 l\u1ec7 b\u1ecf phi\u1ebfu 4-3, c\u00e1c th\u00e0nh vi\u00ean h\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb Daniel, Sherri Greenberg, Shannon Jones v\u00e0 Maram Musetif \u0111\u00e3 b\u1ecf phi\u1ebfu \u1ee7ng h\u1ed9 \u0111\u1ed9ng th\u00e1i h\u1ea1n ch\u1ebf ngu\u1ed3n qu\u1ef9 v\u00e0 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh v\u1ec1 vi\u1ec7c gi\u1ea3i th\u1ec3 Sendero. Julie Oliver, Cynthia Valadez v\u00e0 Ch\u1ee7 t\u1ecbch H\u1ed9i \u0111\u1ed3ng Qu\u1ea3n tr\u1ecb, Ti\u1ebfn s\u0129 Guadalupe Zamora \u0111\u00e3 b\u1ecf phi\u1ebfu ch\u1ed1ng l\u1ea1i \u0111\u1ed9ng th\u00e1i n\u00e0y.<\/p>\n
Th\u00e0nh vi\u00ean H\u1ed9i \u0111\u1ed3ng Qu\u1ea3n tr\u1ecb, Ti\u1ebfn s\u0129 Charles Bell, \u0111\u00e3 b\u1ecf phi\u1ebfu tr\u1eafng, vi\u1ec7n d\u1eabn l\u00fd do \u00f4ng l\u00e0 th\u00e0nh vi\u00ean H\u1ed9i \u0111\u1ed3ng Qu\u1ea3n tr\u1ecb Sendero (Bell l\u00e0 ch\u1ee7 t\u1ecbch H\u1ed9i \u0111\u1ed3ng Qu\u1ea3n tr\u1ecb Sendero), v\u00e0 Ti\u1ebfn s\u0129 Abigail Aiken v\u1eafng m\u1eb7t do c\u00f4ng t\u00e1c qu\u1ed1c t\u1ebf. Quy\u1ebft \u0111\u1ecbnh c\u1ee7a Central Health t\u00f9y thu\u1ed9c v\u00e0o s\u1ef1 ch\u1ea5p thu\u1eadn c\u1ee7a H\u1ed9i \u0111\u1ed3ng Qu\u1ea3n tr\u1ecb Sendero.<\/p>\n
Kho\u1ea3n \u0111\u1ea7u t\u01b0 Central Health tr\u1ecb gi\u00e1 $24 tri\u1ec7u \u0111\u00f4 la s\u1ebd cung c\u1ea5p cho Sendero \u0111\u1ee7 v\u1ed1n v\u00e0 th\u1eb7ng d\u01b0 \u0111\u1ec3 k\u1ebft th\u00fac n\u0103m d\u01b0\u01a1ng l\u1ecbch 2018, v\u00e0 \u0111\u1ee7 ti\u1ec1n \u0111\u1ec3 thanh l\u00fd c\u00f4ng ty m\u1ed9t c\u00e1ch c\u00f3 tr\u00e1ch nhi\u1ec7m v\u00e0o n\u0103m 2019, t\u00f9y thu\u1ed9c v\u00e0o quy\u1ebft \u0111\u1ecbnh c\u1ee7a h\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb Sendero, \u0111\u1ed3ng th\u1eddi h\u1ea1n ch\u1ebf m\u1ecdi r\u1ee7i ro t\u00e0i ch\u00ednh trong t\u01b0\u01a1ng lai \u0111\u1ed1i v\u1edbi Central Health. Ngo\u00e0i ngu\u1ed3n v\u1ed1n t\u00e0i tr\u1ee3 cho n\u0103m t\u00e0i ch\u00ednh 2019, Central Health s\u1ebd c\u1ea7n \u0111\u1ea7u t\u01b0 th\u00eam v\u1ed1n trong n\u0103m t\u00e0i ch\u00ednh 2020 \u0111\u1ec3 trang tr\u1ea3i c\u00e1c chi ph\u00ed li\u00ean quan \u0111\u1ebfn vi\u1ec7c thanh l\u00fd.<\/p>\n
\u201cT\u00f4i tr\u00e2n tr\u1ecdng nh\u1eefng n\u1ed7 l\u1ef1c v\u00e0 c\u00f4ng s\u1ee9c m\u00e0 c\u00e1c b\u1ea1n \u0111\u00e3 b\u1ecf ra cho d\u1ef1 \u00e1n n\u00e0y,\u201d Ch\u1ee7 t\u1ecbch ki\u00eam T\u1ed5ng gi\u00e1m \u0111\u1ed1c \u0111i\u1ec1u h\u00e0nh Sendero Wes Durkalski ph\u00e1t bi\u1ec3u v\u1edbi c\u00e1c th\u00e0nh vi\u00ean h\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb. \u201cCh\u00fang t\u00f4i v\u00f4 c\u00f9ng c\u1ea3m k\u00edch s\u1ef1 \u1ee7ng h\u1ed9 c\u1ee7a c\u00e1c b\u1ea1n trong nh\u1eefng n\u0103m qua, v\u00e0 ch\u00fang t\u00f4i t\u1ef1 h\u00e0o v\u1ec1 nh\u1eefng g\u00ec m\u00ecnh \u0111\u00e3 l\u00e0m. Ch\u00fang t\u00f4i \u0111\u00e3 c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe c\u1ed9ng \u0111\u1ed3ng v\u00e0 gi\u00fap c\u1ed9ng \u0111\u1ed3ng ti\u1ebft ki\u1ec7m \u0111\u01b0\u1ee3c r\u1ea5t nhi\u1ec1u ti\u1ec1n \u2013 t\u1ea5t c\u1ea3 ch\u00fang t\u00f4i \u0111\u1ec1u t\u1ef1 h\u00e0o v\u1ec1 \u0111i\u1ec1u \u0111\u00f3.\u201d<\/p>\n
N\u0103m nay l\u00e0 m\u1ed9t n\u0103m \u0111\u1ea7y th\u00e1ch th\u1ee9c \u0111\u1ed1i v\u1edbi Sendero do nh\u1eefng thay \u0111\u1ed5i trong Ch\u01b0\u01a1ng tr\u00ecnh \u0110i\u1ec1u ch\u1ec9nh R\u1ee7i ro theo \u0110\u1ea1o lu\u1eadt Ch\u0103m s\u00f3c Gi\u00e1 c\u1ea3 Ph\u1ea3i ch\u0103ng (ACA) v\u00e0 th\u1ecb tr\u01b0\u1eddng b\u1ea3o hi\u1ec3m STAR Medicaid v\u00e0 Chip. Ch\u01b0\u01a1ng tr\u00ecnh \u0110i\u1ec1u ch\u1ec9nh R\u1ee7i ro ACA \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 b\u1ed3i th\u01b0\u1eddng cho c\u00e1c c\u00f4ng ty b\u1ea3o hi\u1ec3m tr\u00ean th\u1ecb tr\u01b0\u1eddng c\u00f3 th\u00e0nh vi\u00ean m\u1eafc b\u1ec7nh n\u1eb7ng h\u01a1n v\u00e0 c\u1ea7n nhi\u1ec1u d\u1ecbch v\u1ee5 h\u01a1n, d\u1eabn \u0111\u1ebfn chi ph\u00ed cao h\u01a1n. Tuy nhi\u00ean, c\u00e1c c\u00f4ng ty b\u1ea3o hi\u1ec3m c\u00f3 s\u1ed1 l\u01b0\u1ee3ng th\u00e0nh vi\u00ean kh\u1ecfe m\u1ea1nh h\u01a1n nh\u01b0 Sendero ph\u1ea3i tr\u1ea3 ti\u1ec1n v\u00e0o Ch\u01b0\u01a1ng tr\u00ecnh \u0110i\u1ec1u ch\u1ec9nh R\u1ee7i ro thay v\u00ec nh\u1eadn ti\u1ec1n. Nh\u1eefng kho\u1ea3n thanh to\u00e1n n\u00e0y l\u00ean t\u1edbi h\u00e0ng tri\u1ec7u \u0111\u00f4 la.<\/p>\n
V\u00e0o th\u00e1ng 1, H\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb Central Health \u0111\u00e3 b\u1ecf phi\u1ebfu \u0111\u1ea7u t\u01b0 th\u00eam $26 tri\u1ec7u, n\u00e2ng t\u1ed5ng s\u1ed1 ti\u1ec1n trong n\u0103m t\u00e0i ch\u00ednh 2018 l\u00ean $36 tri\u1ec7u v\u00e0o Sendero v\u00ec Ch\u01b0\u01a1ng tr\u00ecnh \u0111i\u1ec1u ch\u1ec9nh r\u1ee7i ro kh\u00f4ng ho\u00e0n tr\u1ea3 \u0111\u1ea7y \u0111\u1ee7 cho Sendero \u0111\u1ed1i v\u1edbi c\u00e1c d\u1ecbch v\u1ee5 \u0111\u01b0\u1ee3c cung c\u1ea5p th\u00f4ng qua b\u1ea3o hi\u1ec3m Idealcare.<\/p>\n
V\u00e0o th\u00e1ng 3 n\u0103m 2018, Sendero \u0111\u00e3 th\u00f4ng b\u00e1o r\u00fat kh\u1ecfi th\u1ecb tr\u01b0\u1eddng b\u1ea3o hi\u1ec3m STAR Medicaid v\u00e0 CHIP, ch\u1ee7 y\u1ebfu v\u00ec ph\u00ed b\u1ea3o hi\u1ec3m kh\u00f4ng \u0111\u1ee7 kh\u1ea3 n\u0103ng chi tr\u1ea3 chi ph\u00ed ch\u0103m s\u00f3c d\u1ef1 ki\u1ebfn cho c\u00e1c th\u00e0nh vi\u00ean. Kho\u1ea3ng 18.000 th\u00e0nh vi\u00ean Sendero \u0111\u00e3 \u0111\u0103ng k\u00fd c\u00e1c ch\u01b0\u01a1ng tr\u00ecnh b\u1ea3o hi\u1ec3m STAR Medicaid v\u00e0 CHIP c\u1ee7a Sendero \u0111\u00e3 \u0111\u01b0\u1ee3c th\u00f4ng b\u00e1o v\u1ec1 s\u1ef1 thay \u0111\u1ed5i n\u00e0y v\u00e0 \u0111\u00e3 chuy\u1ec3n \u0111\u1ed5i li\u1ec1n m\u1ea1ch sang ph\u1ea1m vi b\u1ea3o hi\u1ec3m m\u1edbi.<\/p>\n
C\u00e1c b\u01b0\u1edbc ti\u1ebfp theo
\nCh\u1ee7 t\u1ecbch ki\u00eam T\u1ed5ng gi\u00e1m \u0111\u1ed1c \u0111i\u1ec1u h\u00e0nh Central Health, Mike Geeslin, \u0111ang so\u1ea1n th\u1ea3o m\u1ed9t l\u00e1 th\u01b0 gi\u1ea3i th\u00edch quy\u1ebft \u0111\u1ecbnh c\u1ee7a h\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb, theo y\u00eau c\u1ea7u c\u1ee7a T\u00f2a \u00e1n \u1ee6y vi\u00ean Qu\u1eadn Travis, n\u00eau r\u00f5 c\u00e1ch Central Health s\u1ebd h\u1ea1n ch\u1ebf r\u1ee7i ro trong t\u01b0\u01a1ng lai v\u1edbi Sendero. Ng\u00e2n s\u00e1ch c\u1ee7a Central Health, bao g\u1ed3m c\u1ea3 kho\u1ea3n \u0111\u1ea7u t\u01b0 Sendero \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t, ph\u1ea3i \u0111\u01b0\u1ee3c H\u1ed9i \u0111\u1ed3ng \u1ee6y vi\u00ean Qu\u1eadn Travis ph\u00ea duy\u1ec7t. C\u00e1c quy\u1ebft \u0111\u1ecbnh ho\u1ea1t \u0111\u1ed9ng trong t\u01b0\u01a1ng lai li\u00ean quan \u0111\u1ebfn Sendero ph\u1ea3i \u0111\u01b0\u1ee3c h\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb ph\u00ea duy\u1ec7t.<\/p>\n
"L\u00e1 th\u01b0 s\u1ebd gi\u1ea3i th\u00edch l\u00fd do \u0111\u1eb1ng sau quy\u1ebft \u0111\u1ecbnh c\u1ee7a qu\u00fd v\u1ecb v\u00e0 x\u00e1c nh\u1eadn kho\u1ea3n h\u1ed7 tr\u1ee3 t\u00e0i ch\u00ednh \u0111\u01b0\u1ee3c Central Health ph\u00ea duy\u1ec7t cho Sendero cho n\u0103m t\u00e0i ch\u00ednh t\u1edbi", Geeslin n\u00f3i. "T\u1ea5t nhi\u00ean, ch\u00fang t\u00f4i s\u1ebd c\u1eadp nh\u1eadt cho c\u1ed9ng \u0111\u1ed3ng v\u00e0 c\u00e1c \u1ee7y vi\u00ean m\u1ecdi b\u01b0\u1edbc trong qu\u00e1 tr\u00ecnh n\u00e0y, \u0111\u1ed3ng th\u1eddi n\u1ed7 l\u1ef1c \u0111\u1ec3 qu\u00e1 tr\u00ecnh chuy\u1ec3n \u0111\u1ed5i di\u1ec5n ra su\u00f4n s\u1ebb nh\u1ea5t c\u00f3 th\u1ec3 cho c\u00e1c th\u00e0nh vi\u00ean Sendero." Geeslin l\u01b0u \u00fd r\u1eb1ng k\u1ec3 t\u1eeb n\u0103m 2012, Sendero \u0111\u00e3 cung c\u1ea5p h\u01a1n $470 tri\u1ec7u \u0111\u00f4 la b\u1ea3o hi\u1ec3m y t\u1ebf cho 135.000 ng\u01b0\u1eddi d\u00e2n t\u1ea1i Qu\u1eadn Travis. "Kho\u1ea3n \u0111\u1ea7u t\u01b0 n\u00e0y l\u00e0 x\u1ee9ng \u0111\u00e1ng", Geeslin n\u00f3i.<\/p>\n
Th\u1eddi gian \u0111\u0103ng k\u00fd m\u1edf c\u1ee7a ACA di\u1ec5n ra t\u1eeb ng\u00e0y 1 th\u00e1ng 11 \u0111\u1ebfn ng\u00e0y 15 th\u00e1ng 12 n\u0103m 2018. Khi th\u1eddi gian \u0111\u0103ng k\u00fd m\u1edf b\u1eaft \u0111\u1ea7u v\u00e0o ng\u00e0y 1 th\u00e1ng 11, c\u00e1c th\u00e0nh vi\u00ean IdealCare c\u1ee7a Sendero n\u00ean g\u1ecdi 2-1-1 \u0111\u1ec3 \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 mi\u1ec5n ph\u00ed trong vi\u1ec7c l\u1ef1a ch\u1ecdn g\u00f3i b\u1ea3o hi\u1ec3m y t\u1ebf cho n\u0103m 2019. N\u1ebfu c\u00e1c th\u00e0nh vi\u00ean c\u00f3 th\u1eafc m\u1eafc h\u00f4m nay, h\u1ecd c\u00f3 th\u1ec3 g\u1ecdi \u0111\u1ebfn s\u1ed1 512-978-8855.<\/p>\n
(Austin) \u2013 El Consejo de Directores de Central Health \u0111\u00e3 b\u1ecf phi\u1ebfu v\u00e0o ng\u00e0y 12 th\u00e1ng 9 \u0111\u1ec3 gi\u1edbi h\u1ea1n t\u00e0i ch\u00ednh cho c\u00e1c Ch\u01b0\u01a1ng tr\u00ecnh Y t\u1ebf Sendero, su organizaci\u00f3n de mantenimiento de la salud (HMO, por sus siglas en ingl\u00e9s) v\u00ec ti\u1ec1n ph\u1ea1t, debido a los constantes v\u00e0 potencialmente mayores desaf\u00edos nh\u00e0 t\u00e0i ch\u00ednh que la compa\u00f1\u00eda ha estado enfrentando.<\/p>\n
Sendero Health Plans \u0111\u01b0\u1ee3c th\u00e0nh l\u1eadp v\u00e0o n\u0103m 2012 b\u1edfi Central Health \u0111\u1ec3 c\u00e2n \u0111\u1ed1i gi\u1eefa y t\u1ebf v\u00e0 c\u00e1c c\u00e1 nh\u00e2n t\u00e1i di\u1ec5n kinh t\u1ebf. S\u1ea3n ph\u1ea9m c\u1ee7a h\u1ecd, IdealCare, th\u1ef1c t\u1ebf c\u00f3 gi\u00e1 tr\u1ecb v\u1edbi 24.000 tri\u1ec7u \u0111\u00f4 la. La cobertura de seguro medico que ofrece estar\u00e1 vigente durante todo el 2018. En el pr\u00f3ximo per\u00edodo de inscripciones abiertas bajo la Ley de Cuidados M\u00e9dicos (ACA, por sus siglas en ingl\u00e9s), los miembros tensr\u00e1n la c\u01a1 h\u1ed9i l\u1ef1a ch\u1ecdn k\u1ebf ho\u1ea1ch seguro medico b\u1ea1n n\u00ean \u01b0u ti\u00ean cho n\u0103m 2019. Nh\u01b0 m\u1ed9t trung gian, Ng\u01b0\u1eddi g\u1eedi \u0111\u01b0\u1ee3c xem x\u00e9t cung c\u1ea5p k\u1ebf ho\u1ea1ch IdealCare Bronze trong n\u0103m 2019.<\/p>\n
Durante la reuni\u00f3n del Consejo de Directores, el d\u00eda mi\u00e9rcoles, acerca del presupuesto y las tasas imppositivas para el a\u00f1o t\u00e0i ch\u00ednh (FY, por sus siglas en ingl\u00e9s) 2019, y despu\u00e9s de llevar a cabo un an\u00e1lisis Drainivo y dedicarle muchas horas de discusi\u00f3n al tema durante los \u00faltimos Trong khi \u0111\u00f3, th\u1ecb tr\u01b0\u1edfng c\u1ee7a bang h\u1ed9i \u0111\u1ed3ng gi\u00e1m \u0111\u1ed1c Central Health quy\u1ebft \u0111\u1ecbnh th\u1eddi \u0111\u1ea1i ng\u01b0\u1eddi \u0111\u01b0\u1ee3c h\u01b0\u1edfng l\u1ee3i t\u1eeb vi\u1ec7c l\u00e0m c\u1ee7a t\u00f4i trong t\u01b0\u01a1ng lai v\u00e0 bu\u1ed9c ph\u1ea3i t\u1ea1m d\u1eebng m\u1ed9t c\u00e1ch ch\u1ecbu tr\u00e1ch nhi\u1ec7m v\u1ec1 c\u00e1c ho\u1ea1t \u0111\u1ed9ng c\u1ee7a Sendero.<\/p>\n
M\u1ed9t ng\u01b0\u1eddi b\u1ecb \u0111\u1ed1i \u0111\u1ea7u v\u1edbi Sendero, Ch\u1ee7 t\u1ecbch c\u1ee7a Hi\u1ec7p h\u1ed9i Central Health, Ti\u1ebfn s\u0129 Guadalupe Zamora, \u0111\u00e3 g\u1eb7p kh\u00f3 kh\u0103n khi \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh cho Consejo. \u201cLes ped\u00ed que vinieran con una mente abierta,\u201d dijo el Dr. Zamora. "Hemos ph\u00e2n t\u00edch s\u1ed1 l\u01b0\u1ee3ng l\u1edbn s\u1ed1 v\u00e0 c\u1ea3m x\u00fac th\u1ea3o lu\u1eadn v\u1ec1 t\u01b0\u01a1ng lai c\u1ee7a Sendero. Cu\u1ed1i c\u00f9ng, apoyo la decisi\u00f3n de aquellos que votaron para empezar t\u1ea1m d\u1eebng las actividades de la compa\u00f1\u00eda, v\u00e0 s\u00e9 que todos estamos muy tristes de haber tenido que tomar esta decisi\u00f3n tan kh\u00f3 kh\u0103n."<\/p>\n
Ng\u01b0\u1eddi \u0111\u1ee9ng \u0111\u1ea7u Consejo, Katrina Daniel, C\u1ef1u Ch\u1ee7 t\u1ecbch Consejo c\u1ee7a Gi\u00e1m \u0111\u1ed1c Central Health, tr\u00ecnh b\u00e0y v\u1ec1 \u0111\u1ed9ng th\u00e1i t\u0103ng c\u01b0\u1eddng \u0111\u1ea3o ng\u01b0\u1ee3c Central Health v\u00e0 g\u1eedi cho n\u0103m t\u00e0i ch\u00ednh 2019 c\u1ee7a $4 h\u00e0ng tri\u1ec7u ng\u01b0\u1eddi b\u1ed5 sung, n\u00e2ng cao kh\u1ea3 n\u0103ng \u0111\u1ea3o ng\u01b0\u1ee3c t\u1ed5ng c\u1ed9ng $24 tri\u1ec7u. \u0110\u00e2y l\u00e0 s\u1ef1 \u0111\u1ea3o ng\u01b0\u1ee3c t\u00e0i ch\u00ednh v\u1edbi chi ph\u00ed v\u1ed1n v\u00e0 c\u00e1c ph\u00f3ng vi\u00ean kinh doanh, v\u1edbi \u0111i\u1ec1u ki\u1ec7n l\u00e0 ng\u01b0\u1eddi g\u1eedi s\u1ebd th\u1ef1c hi\u1ec7n c\u00e1c ho\u1ea1t \u0111\u1ed9ng sau kho\u1ea3ng th\u1eddi gian d\u1ef1 ki\u1ebfn.<\/p>\n
\u201cAnh \u1ea5y \u0111\u00e3 t\u1ea1o ra m\u1ed9t \u0111\u1ed9ng l\u1ef1c l\u1edbn cho Sendero los \u00faltimos a\u00f1os y creo que invertimos en la compa\u00f1\u00eda por todas las razones Correctas,\u201d Daniel gi\u1ea3i th\u00edch. "Sendero ha enfrentado muchos desaf\u00edos a lo largo de los a\u00f1os, incluyendo mucha compencia en el mercado de seguros en un un principio y la incertidumbre que rodea al ACA hoy en d\u00eda. No perdimos dinero \u2013invertimos en la salud de las Personas. Sin c\u1ea5m v\u1eadn, creo que ha llegado el momento de buscar un nuevo camino para Central Health que ch\u1ee9ng minh \u0111i\u1ec1u \u0111\u00f3 ch\u1eafc ch\u1eafn v\u00e0 \u1ed5n \u0111\u1ecbnh t\u00e0i ch\u00ednh.\u201d
\n-m\u00e1s-<\/p>\n
Trong cu\u1ed9c b\u1ecf phi\u1ebfu 4 v\u00e0 3, c\u00e1c b\u1ea1n c\u1ee7a Consejo Daniel, Sherri Greenberg, Shannon Jones v\u00e0 Maram Musetif \u0111\u00e3 b\u1ecf phi\u1ebfu \u1ee7ng h\u1ed9 chuy\u1ec3n \u0111\u1ed9ng gi\u1edbi h\u1ea1n c\u00e1c l\u01b0\u1ee3t th\u00edch v\u00e0 tham gia v\u00e0o c\u00f4ng vi\u1ec7c c\u1ee7a c\u00e1c ho\u1ea1t \u0111\u1ed9ng c\u1ee7a Sendero. Julie Oliver, Cynthia Valadez v\u00e0 Ch\u1ee7 t\u1ecbch Consejo, Ti\u1ebfn s\u0129 Guadalupe Zamora, b\u1ecf phi\u1ebfu v\u00e0 ng\u01b0\u1ee3c l\u1ea1i.<\/p>\n
El miembro del Consejo Dr. Charles Bell, quy\u1ebft \u0111\u1ecbnh b\u1ecf phi\u1ebfu tr\u1eafng, razonando su voto como miembro del Consejo de Directores de Sendero (Bell es Presidente del Consejo de Directores de Sendero), v\u00e0 la Dra. Abigail Aiken \u0111\u00e3 b\u1eaft \u0111\u1ea7u th\u1ea3o lu\u1eadn v\u1ec1 m\u1ed9t m\u1ed1i quan h\u1ec7 qu\u1ed1c t\u1ebf th\u00f4ng qua giao d\u1ecbch c\u1ee7a b\u1ea1n. Quy\u1ebft \u0111\u1ecbnh c\u1ee7a Central Health l\u00e0 m\u1ed9t s\u1ef1 ph\u1ea3n \u0111\u1ed1i c\u1ee7a Consejo de Sendero.<\/p>\n
S\u1ef1 \u0111\u1ea3o ng\u01b0\u1ee3c c\u1ee7a $24 tri\u1ec7u \u0111\u00f4 la t\u1eeb Central Health \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng Sendero c\u00f3 \u0111\u1ee7 v\u1ed1n v\u00e0 m\u1ed9t s\u1ed1 d\u01b0 th\u1eeba \u0111\u1ec3 c\u00f3 th\u1ec3 k\u1ebft th\u00fac giai \u0111o\u1ea1n cu\u1ed1i n\u0103m 2018, v\u00e0 c\u00f3 \u0111\u1ee7 n\u1ec1n t\u1ea3ng \u0111\u1ec3 c\u00f3 \u0111\u01b0\u1ee3c tr\u00e1ch nhi\u1ec7m cao nh\u1ea5t v\u1ec1 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u00f4ng ty trong n\u0103m 2019, d\u1ef1 ki\u1ebfn th\u1ef1c hi\u1ec7n Consejo de Sendero, trung t\u00e2m que se limita cualquier riesgo futuro para Central Health. Gi\u1ea3i quy\u1ebft v\u1ea5n \u0111\u1ec1 t\u00e0i ch\u00ednh cho n\u0103m t\u00e0i ch\u00ednh 2019, Central Health c\u1ea7n ph\u1ea3i \u0111\u1ea3o ng\u01b0\u1ee3c c\u00e1c kho\u1ea3n b\u1ed5 sung v\u00e0 t\u00e0i ch\u00ednh n\u0103m 2020 \u0111\u1ec3 chu\u1ea9n b\u1ecb cho vi\u1ec7c kinh doanh li\u00ean quan \u0111\u1ebfn ho\u1ea1t \u0111\u1ed9ng c\u1ee7a h\u1ecd.<\/p>\n
\u201cAgradezco el esfuerzo y c\u1ed1ng hi\u1ebfn que le han puesto a este tema,\u201d b\u00e0y t\u1ecf v\u1ec1 los miembros del Consejo el Presidente v\u00e0 Gerente General de Sendero, Wes Durkalski. "Apreciamos much\u00edsimo su apoyo durante estos a\u00f1os, y estamos orgullosos del trabajo que hemos realizado. Hemos mejorado la salud de la comunidad y ayudado a la comunidad a ahorrarse mucho dinero \u2013todos estamos orgullosos de esto."<\/p>\n
\u0110\u00e2y l\u00e0 m\u1ed9t trong nh\u1eefng kh\u00f3 kh\u0103n m\u00e0 ng\u01b0\u1eddi g\u1eedi \u0111\u00e3 gi\u1ea3i th\u00edch v\u1ec1 c\u00e1c y\u1ebfu t\u1ed1 bao g\u1ed3m c\u00e1c cambios c\u1ee7a Ch\u01b0\u01a1ng tr\u00ecnh Ajuste de Riesgos cho Ley de Cuidados M\u00e9dicos v\u00e0 th\u01b0\u01a1ng m\u1ea1i b\u1ea3o \u0111\u1ea3m y t\u1ebf STAR Medicaid v\u00e0 Chip. Ch\u01b0\u01a1ng tr\u00ecnh Ajuste de Riesgos d\u00e0nh cho ACA \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 b\u00f9 \u0111\u1eafp cho c\u00e1c d\u1ecbch v\u1ee5 b\u1ea3o \u0111\u1ea3m b\u1eb1ng th\u01b0\u01a1ng m\u1ea1i y t\u1ebf b\u1ea3o \u0111\u1ea3m cho nh\u1eefng ng\u01b0\u1eddi d\u00e2n c\u1ee7a t\u00f4i \u0111ang \u0111\u01b0\u1ee3c cung c\u1ea5p nhi\u1ec1u d\u1ecbch v\u1ee5 h\u01a1n v\u00e0 c\u1ea7n nhi\u1ec1u d\u1ecbch v\u1ee5 h\u01a1n, m\u00e0 chi ph\u00ed c\u1ee7a h\u1ecd cao h\u01a1n. Trong l\u1ec7nh c\u1ea5m v\u1eadn, las compa\u00f1\u00edas de seguros y t\u1ebf v\u1edbi m\u1ed9t s\u1ed1 th\u1ecb tr\u01b0\u1edfng de clientes m\u00e1s saludables, nh\u1eefng c\u00e2u chuy\u1ec7n nh\u01b0 Sendero, deben hacer pagos al Programa de Ajuste de Riesgos, v\u00e0 vez de recibir fondos. \u0110\u00e2y l\u00e0 s\u1ed1 ti\u1ec1n ki\u1ebfm \u0111\u01b0\u1ee3c h\u00e0ng tri\u1ec7u \u0111\u00f4 la.<\/p>\n
Trong \u0111\u00f3, Consejo de Directores de Central Health \u0111\u00e3 b\u1ecf phi\u1ebfu \u0111\u1ec3 \u0111\u1ea3o ng\u01b0\u1ee3c $26 tri\u1ec7u \u0111\u00f4 la b\u1ed5 sung cho n\u0103m t\u00e0i ch\u00ednh 2018, \u0111\u1ec3 t\u1ed5ng h\u1ee3p t\u1ed5ng s\u1ed1 $36 tri\u1ec7u \u0111\u00f4 la \u1edf Sendero, h\u00e3y gi\u1ea3i quy\u1ebft v\u1ea5n \u0111\u1ec1 v\u1ec1 Ch\u01b0\u01a1ng tr\u00ecnh \u0111i\u1ec1u ch\u1ec9nh c\u1ee7a Riesgos kh\u00f4ng c\u00f3 kho\u1ea3n \u0111\u1ec1n b\u00f9 n\u00e0o cho Sendero b\u1edfi c\u00e1c d\u1ecbch v\u1ee5 \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng b\u1ea1n \u0111\u00e3 th\u1ef1c hi\u1ec7n m\u1ed9t h\u00e0nh tr\u00ecnh aseguradora Idealcare.<\/p>\n
V\u00e0o th\u00e1ng 3 n\u0103m 2018, Ng\u01b0\u1eddi g\u1eedi \u0111\u00e3 th\u00f4ng b\u00e1o v\u1ec1 vi\u1ec7c ngh\u1ec9 h\u01b0u c\u1ee7a ng\u01b0\u1eddi b\u00e1n b\u1ea3o hi\u1ec3m STAR Medicaid v\u00e0 CHIP, v\u1ec1 c\u01a1 b\u1ea3n l\u00e0 porque las primas de los seguros no cur\u00edan el costo proyectado de los cuidados de sus miembros. Kho\u1ea3ng 18.000 miembros de Sendero que estaban vi\u1ebft th\u01b0 tr\u00ean c\u00e1c m\u00e1y bay b\u1ea3o \u0111\u1ea3m y t\u1ebf STAR Medicaid v\u00e0 CHIP fueron notificados de estos cambios v\u00e0 fueron trasladados sin mayores dificultades a otros m\u00e1y bay cobertura medica.<\/p>\n
Pr\u00f3ximos Pasos
\nTu\u00e2n th\u1ee7 y\u00eau c\u1ea7u \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y b\u1edfi Corte del Comisionado de Travis, Ch\u1ee7 t\u1ecbch v\u00e0 Gerente General c\u1ee7a Junta Directiva c\u1ee7a Central Health, Mike Geeslin, \u0111\u00e3 chu\u1ea9n b\u1ecb m\u1ed9t b\u1ea3n \u0111\u1ed3 gi\u1ea3i th\u00edch quy\u1ebft \u0111\u1ecbnh c\u1ee7a Consejo \u0111\u1ec3 m\u00f4 t\u1ea3 gi\u1edbi h\u1ea1n Central Health c\u1ee7a b\u1ea1n v\u1ec1 c\u00e1c v\u1ea5n \u0111\u1ec1 t\u01b0\u01a1ng lai v\u1edbi Sendero. Gi\u1ea3 \u0111\u1ecbnh c\u1ee7a Central Health, bao g\u1ed3m c\u1ea3 c\u00f4ng c\u1ee5 \u0111\u1ea3o ng\u01b0\u1ee3c v\u00e0 Sendero, \u0111\u00e3 g\u00e2y ra s\u1ef1 c\u1ed1 v\u1edbi \u1ee6y ban Condado c\u1ee7a Travis. Nh\u1eefng quy\u1ebft \u0111\u1ecbnh trong t\u01b0\u01a1ng lai v\u1ec1 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a Sendero s\u1ebd \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi Consejo.<\/p>\n
\u201cEsta carta gi\u1ea3i th\u00edch l\u00fd do \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh m\u1edbi v\u00e0 x\u00e1c nh\u1eadn kh\u1ea3 n\u0103ng t\u00e0i tr\u1ee3 c\u1ee7a Central Health cho Sendero para el siguiente a\u00f1o t\u00e0i ch\u00ednh,\u201d Geeslin b\u00e0y t\u1ecf. \u201cV\u00ec l\u00fd do n\u00e0o \u0111\u00f3, b\u1ea1n c\u00f3 th\u1ec3 li\u00ean h\u1ec7 v\u1edbi ch\u00fang t\u00f4i \u0111\u1ec3 c\u00f3 \u0111\u01b0\u1ee3c th\u00f4ng tin v\u1ec1 cada paso del camino, v\u00e0 trabajaremos para que la transici\u00f3n sea lo m\u00e1s f\u00e1cil posible para los miembros de Sendero.\u201d Geeslin explic\u00f3 que desde el 2012 Sendero \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng $470 tri\u1ec7u \u0111\u00f4 la trong ng\u00e0nh y t\u1ebf v\u1edbi h\u01a1n 135.000 nh\u00e2n v\u1eadt c\u1ee7a Condado de Travis. \u201cS\u1ef1 \u0111\u1ea3o ng\u01b0\u1ee3c c\u00f3 gi\u00e1 tr\u1ecb h\u1ee3p l\u1ec7,\u201d Geeslin k\u1ebft lu\u1eadn.<\/p>\n
Th\u1eddi \u0111i\u1ec3m ghi ch\u00fa c\u1ee7a ACA v\u00e0 ng\u00e0y 15 th\u00e1ng 11 n\u0103m 2018. C\u00f3 th\u1ec3 ghi ch\u00fa v\u1ec1 vi\u1ec7c b\u1eaft \u0111\u1ea7u v\u00e0o ng\u00e0y 1 th\u00e1ng 10, los miembros de IdealCare de Sendero deben llamar al 2-1-1 \u0111\u1ec3 nh\u1eadn \u0111\u01b0\u1ee3c ayuda mi\u1ec5n ph\u00ed \u0111\u1ec3 \u0111\u1ed1i \u0111\u1ea7u v\u1edbi k\u1ebf ho\u1ea1ch b\u1ea3o \u0111\u1ea3m y t\u1ebf cho b\u1ea1n 2019. N\u1ebfu los miembros tienen alguna mang l\u1ea1i cho b\u1ea1n ng\u00e0y h\u00f4m nay, b\u1ea1n c\u00f3 th\u1ec3 \u0111\u00e1nh d\u1ea5u s\u1ed1 \u0111i\u1ec7n tho\u1ea1i 512-978-8855.<\/p>\n
H\u1ed9i \u0111\u1ed3ng Qu\u1ea3n l\u00fd Central Health s\u1ebd t\u1ed5 ch\u1ee9c m\u1ed9t cu\u1ed9c h\u1ecdp \u0111\u1eb7c bi\u1ec7t v\u00e0o l\u00fac 1 gi\u1edd chi\u1ec1u Th\u1ee9 B\u1ea3y, ng\u00e0y 22 th\u00e1ng 9 \u0111\u1ec3 th\u1ea3o lu\u1eadn th\u00eam v\u1ec1 c\u00e1c Ch\u01b0\u01a1ng tr\u00ecnh B\u1ea3o hi\u1ec3m Y t\u1ebf Sendero. N\u1ed9i dung trao \u0111\u1ed5i v\u1edbi ng\u01b0\u1eddi d\u00e2n s\u1ebd \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o ch\u01b0\u01a1ng tr\u00ecnh ngh\u1ecb s\u1ef1, cho ph\u00e9p ng\u01b0\u1eddi d\u00e2n \u0111\u00f3ng g\u00f3p \u00fd ki\u1ebfn (c\u00e1c h\u01b0\u1edbng d\u1eabn th\u00f4ng th\u01b0\u1eddng s\u1ebd \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng<\/a>).<\/strong><\/p>\n Cu\u1ed9c h\u1ecdp s\u1ebd \u0111\u01b0\u1ee3c ph\u00e1t tr\u1ef1c ti\u1ebfp tr\u00ean trang Cu\u1ed9c h\u1ecdp<\/a> v\u00e0 tr\u00ean c\u1ee7a ch\u00fang t\u00f4i K\u00eanh YouTube<\/a>.<\/strong><\/p>\n