(Austin, TX) \u2013 Khi K\u1ef3 \u0111\u0103ng k\u00fd m\u1edf n\u0103m 2020 m\u1edf ra v\u00e0o th\u1ee9 S\u00e1u, ng\u00e0y 1 th\u00e1ng 11, Central Health v\u00e0 Sendero Health Plans, t\u1ed5 ch\u1ee9c b\u1ea3o tr\u00ec s\u1ee9c kh\u1ecfe phi l\u1ee3i nhu\u1eadn (HMO), \u0111ang m\u1edf r\u1ed9ng ch\u01b0\u01a1ng tr\u00ecnh thanh to\u00e1n ph\u00ed b\u1ea3o hi\u1ec3m y t\u1ebf cho c\u01b0 d\u00e2n Qu\u1eadn Travis c\u00f3 nhu c\u1ea7u y t\u1ebf ph\u1ee9c t\u1ea1p.<\/p>\n
Theo ch\u01b0\u01a1ng tr\u00ecnh h\u1ed7 tr\u1ee3 ph\u00ed b\u1ea3o hi\u1ec3m, Central Health chi tr\u1ea3 ph\u00ed b\u1ea3o hi\u1ec3m cho m\u1ed9t nh\u00f3m b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh m\u00e3n t\u00ednh \u0111\u01b0\u1ee3c ch\u1ecdn l\u1ecdc, \u0111\u00e1p \u1ee9ng c\u00e1c ti\u00eau ch\u00ed s\u1ee9c kh\u1ecfe c\u1ee5 th\u1ec3 v\u00e0 \u0111\u01b0\u1ee3c ghi danh v\u00e0o Ch\u01b0\u01a1ng tr\u00ecnh Ti\u1ebfp c\u1eadn Y t\u1ebf (MAP), ch\u01b0\u01a1ng tr\u00ecnh b\u1ea3o hi\u1ec3m c\u1ee7a qu\u1eadn ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe d\u00e0nh cho c\u01b0 d\u00e2n Qu\u1eadn Travis c\u00f3 thu nh\u1eadp th\u1ea5p. Ch\u01b0\u01a1ng tr\u00ecnh n\u00e0y, \u0111\u01b0\u1ee3c ban l\u00e3nh \u0111\u1ea1o Sendero \u0111\u1ec1 xu\u1ea5t v\u00e0o m\u00f9a thu n\u0103m ngo\u00e1i, t\u1eadn d\u1ee5ng c\u00e1c ngu\u1ed3n qu\u1ef9 \u0111\u01b0\u1ee3c cung c\u1ea5p th\u00f4ng qua ch\u01b0\u01a1ng tr\u00ecnh \u0111i\u1ec1u ch\u1ec9nh r\u1ee7i ro c\u1ee7a \u0110\u1ea1o lu\u1eadt Ch\u0103m s\u00f3c Gi\u00e1 c\u1ea3 Ph\u1ea3i ch\u0103ng (ACA). \u0110\u1ed5i l\u1ea1i vi\u1ec7c b\u1ea3o hi\u1ec3m cho nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh n\u1eb7ng h\u01a1n, Sendero k\u1ef3 v\u1ecdng s\u1ebd ki\u1ebfm \u0111\u01b0\u1ee3c h\u00e0ng tri\u1ec7u \u0111\u00f4 la t\u1eeb ch\u01b0\u01a1ng tr\u00ecnh \u0111i\u1ec1u ch\u1ec9nh r\u1ee7i ro n\u00e0y cho vi\u1ec7c ch\u0103m s\u00f3c c\u00e1c th\u00e0nh vi\u00ean c\u1ee7a ch\u01b0\u01a1ng tr\u00ecnh.<\/p>\n
\u201cCh\u01b0\u01a1ng tr\u00ecnh h\u1ed7 tr\u1ee3 ph\u00ed b\u1ea3o hi\u1ec3m \u0111ang ho\u1ea1t \u0111\u1ed9ng \u0111\u00fang nh\u01b0 k\u1ebf ho\u1ea1ch,\u201d Ti\u1ebfn s\u0129 Guadalupe Zamora, b\u00e1c s\u0129 l\u00e2u n\u0103m t\u1ea1i Austin v\u00e0 l\u00e0 ch\u1ee7 t\u1ecbch h\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb c\u1ee7a Central Health, cho bi\u1ebft. \u201cCh\u01b0\u01a1ng tr\u00ecnh n\u00e0y \u0111ang c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe c\u1ee7a nh\u1eefng ng\u01b0\u1eddi ch\u00fang t\u00f4i ph\u1ee5c v\u1ee5 m\u1ed9t c\u00e1ch c\u00f3 tr\u00e1ch nhi\u1ec7m v\u1ec1 m\u1eb7t t\u00e0i ch\u00ednh. N\u0103m nay, ch\u00fang t\u00f4i hy v\u1ecdng s\u1ebd t\u0103ng g\u1ea5p \u0111\u00f4i s\u1ed1 b\u1ec7nh nh\u00e2n l\u1ef1a ch\u1ecdn chuy\u1ec3n \u0111\u1ed5i t\u1eeb MAP sang Sendero, v\u00e0 ch\u00fang t\u00f4i nh\u1eadn th\u1ea5y r\u1eb1ng \u0111i\u1ec1u n\u00e0y c\u1ea7n m\u1ed9t chi\u1ebfn l\u01b0\u1ee3c ti\u1ebfp c\u1eadn c\u1ed9ng \u0111\u1ed3ng chuy\u00ean s\u00e2u \u0111\u1ec3 gi\u00fap b\u1ec7nh nh\u00e2n hi\u1ec3u r\u00f5 c\u00e1c l\u1ef1a ch\u1ecdn c\u1ee7a m\u00ecnh v\u00e0 \u0111\u01b0a ra l\u1ef1a ch\u1ecdn t\u1ed1t nh\u1ea5t cho h\u1ecd.\u201d<\/p>\n
Ch\u01b0\u01a1ng tr\u00ecnh \u0111i\u1ec1u ch\u1ec9nh r\u1ee7i ro \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf nh\u1eb1m \u1ed5n \u0111\u1ecbnh th\u1ecb tr\u01b0\u1eddng b\u1ea3o hi\u1ec3m y t\u1ebf, gi\u00fap c\u00e1c c\u00f4ng ty b\u1ea3o hi\u1ec3m c\u00f3 th\u00e0nh vi\u00ean b\u1ec7nh n\u1eb7ng h\u01a1n c\u00f3 th\u1ec3 r\u00fat ti\u1ec1n t\u1eeb qu\u1ef9 \u0111\u00f3ng g\u00f3p c\u1ee7a c\u00e1c c\u00f4ng ty c\u00f3 th\u00e0nh vi\u00ean kh\u1ecfe m\u1ea1nh h\u01a1n. H\u1ed9i \u0111\u1ed3ng Qu\u1ea3n tr\u1ecb c\u1ee7a Central Health \u0111\u00e3 th\u00f4ng qua k\u1ebf ho\u1ea1ch n\u00e0y v\u00e0o th\u00e1ng 9 n\u0103m 2018, qua \u0111\u00f3 t\u00e0i tr\u1ee3 ph\u00ed b\u1ea3o hi\u1ec3m cho kho\u1ea3ng 500 th\u00e0nh vi\u00ean MAP c\u00f3 nhu c\u1ea7u y t\u1ebf ph\u1ee9c t\u1ea1p \u0111\u00e3 \u0111\u0103ng k\u00fd Sendero. Trong s\u1ed1 500 th\u00e0nh vi\u00ean \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh, h\u01a1n 200 ng\u01b0\u1eddi \u0111\u00e3 ch\u1ecdn chuy\u1ec3n sang ch\u01b0\u01a1ng tr\u00ecnh ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe IdealCare c\u1ee7a Sendero.<\/p>\n
C\u00e1c ch\u01b0\u01a1ng tr\u00ecnh b\u1ea3o hi\u1ec3m t\u01b0 nh\u00e2n nh\u01b0 IdealCare cung c\u1ea5p m\u1ea1ng l\u01b0\u1edbi b\u00e1c s\u0129 r\u1ed9ng h\u01a1n v\u00e0 nhi\u1ec1u d\u1ecbch v\u1ee5 c\u0169ng nh\u01b0 quy\u1ec1n l\u1ee3i h\u01a1n so v\u1edbi MAP ho\u1eb7c c\u00e1c ch\u01b0\u01a1ng tr\u00ecnh b\u1ea3o hi\u1ec3m y t\u1ebf c\u00f4ng kh\u00e1c. Chi\u1ebfn l\u01b0\u1ee3c n\u00e0y c\u0169ng \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 t\u0103ng ng\u00e2n s\u00e1ch ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe cho Sendero, v\u1ed1n \u0111\u00e3 chi tr\u1ea3 $47 tri\u1ec7u \u0111\u00f4 la v\u00e0o ch\u01b0\u01a1ng tr\u00ecnh \u0111i\u1ec1u ch\u1ec9nh r\u1ee7i ro thay v\u00ec r\u00fat ti\u1ec1n ra.<\/p>\n
\u201cB\u1eb1ng c\u00e1ch cung c\u1ea5p b\u1ea3o hi\u1ec3m y t\u1ebf cho nhi\u1ec1u c\u01b0 d\u00e2n m\u1eafc b\u1ec7nh m\u00e3n t\u00ednh, ch\u01b0a c\u00f3 b\u1ea3o hi\u1ec3m trong c\u1ed9ng \u0111\u1ed3ng c\u1ee7a ch\u00fang t\u00f4i, v\u00e0 m\u1ed9t l\u1ea7n n\u1eefa cung c\u1ea5p c\u00e1c g\u00f3i b\u1ea3o hi\u1ec3m ch\u1ea5t l\u01b0\u1ee3ng cao, chi ph\u00ed th\u1ea5p cho t\u1ea5t c\u1ea3 m\u1ecdi ng\u01b0\u1eddi, ch\u00fang t\u00f4i \u0111ang ho\u00e0n th\u00e0nh s\u1ee9 m\u1ec7nh m\u1edf r\u1ed9ng ph\u1ea1m vi b\u1ea3o hi\u1ec3m cho khu v\u1ef1c Austin,\u201d Ch\u1ee7 t\u1ecbch ki\u00eam T\u1ed5ng Gi\u00e1m \u0111\u1ed1c \u0110i\u1ec1u h\u00e0nh Sendero, Wesley Durkalski, ph\u00e1t bi\u1ec3u. \u201cCh\u00fang t\u00f4i t\u1ef1 h\u00e0o v\u1ec1 th\u00e0nh t\u00edch c\u1ee7a Sendero trong vi\u1ec7c h\u1ee3p t\u00e1c v\u1edbi Central Health v\u00e0 m\u1ea1ng l\u01b0\u1edbi nh\u00e0 cung c\u1ea5p r\u1ed9ng kh\u1eafp c\u1ee7a ch\u00fang t\u00f4i \u0111\u1ec3 x\u00e2y d\u1ef1ng m\u1ed9t c\u1ed9ng \u0111\u1ed3ng kh\u1ecfe m\u1ea1nh h\u01a1n cho t\u1ea5t c\u1ea3 m\u1ecdi ng\u01b0\u1eddi.\u201d<\/p>\n
Ch\u01b0\u01a1ng tr\u00ecnh MAP c\u1ee7a Central Health cung c\u1ea5p b\u1ea3o hi\u1ec3m y t\u1ebf cho c\u01b0 d\u00e2n Qu\u1eadn Travis s\u1ed1ng \u1edf m\u1ee9c 100% ho\u1eb7c th\u1ea5p h\u01a1n M\u1ee9c Ngh\u00e8o Li\u00ean bang, nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n tham gia c\u00e1c ch\u01b0\u01a1ng tr\u00ecnh kh\u00e1c nh\u01b0 Medicaid\/CHIP, Medicare ho\u1eb7c b\u1ea3o hi\u1ec3m t\u01b0 nh\u00e2n. \u0110\u1ea7u n\u0103m nay, Central Health \u0111\u00e3 m\u1edf r\u1ed9ng ch\u01b0\u01a1ng tr\u00ecnh v\u1edbi vi\u1ec7c t\u1ea1o ra ch\u01b0\u01a1ng tr\u00ecnh MAP BASIC, bao g\u1ed3m nh\u1eefng ng\u01b0\u1eddi c\u00f3 thu nh\u1eadp cao h\u01a1n nh\u01b0ng cung c\u1ea5p \u00edt quy\u1ec1n l\u1ee3i h\u01a1n v\u00e0 m\u1ee9c \u0111\u1ed3ng thanh to\u00e1n cao h\u01a1n so v\u1edbi ch\u01b0\u01a1ng tr\u00ecnh MAP truy\u1ec1n th\u1ed1ng.<\/p>\n
Trong N\u0103m t\u00e0i ch\u00ednh (FY) 2019, H\u1ed9i \u0111\u1ed3ng Qu\u1ea3n tr\u1ecb c\u1ee7a Central Health \u0111\u00e3 d\u1ef1 tr\u00f9 $6 tri\u1ec7u \u0111\u00f4 la cho ch\u01b0\u01a1ng tr\u00ecnh h\u1ed7 tr\u1ee3 ph\u00ed b\u1ea3o hi\u1ec3m. Trong n\u0103m t\u00e0i ch\u00ednh 2020, h\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb \u0111\u00e3 d\u1ef1 tr\u00f9 $7 tri\u1ec7u \u0111\u00f4 la v\u1edbi m\u1ee5c ti\u00eau tuy\u1ec3n sinh t\u1eeb 300-350 th\u00e0nh vi\u00ean hi\u1ec7n t\u1ea1i c\u1ee7a ch\u01b0\u01a1ng tr\u00ecnh MAP v\u00e0 MAP BASIC v\u00e0o Sendero. \u0110\u1ec3 \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n, b\u1ec7nh nh\u00e2n ph\u1ea3i \u0111\u00e3 \u0111\u0103ng k\u00fd tham gia ch\u01b0\u01a1ng tr\u00ecnh MAP ho\u1eb7c MAP BASIC trong n\u0103m qua, kh\u00f4ng \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n tham gia Medicaid ho\u1eb7c Medicare, v\u00e0 hi\u1ec7n \u0111ang \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n m\u1eafc b\u1ec7nh "m\u00e3n t\u00ednh". \u0110\u1ed3ng th\u1eddi, Sendero \u0111ang ti\u1ebfp c\u1eadn c\u00e1c th\u00e0nh vi\u00ean hi\u1ec7n \u0111ang tham gia ch\u01b0\u01a1ng tr\u00ecnh h\u1ed7 tr\u1ee3 ph\u00ed b\u1ea3o hi\u1ec3m v\u00e0 t\u1ea1o c\u01a1 h\u1ed9i cho h\u1ecd \u0111\u0103ng k\u00fd l\u1ea1i v\u00e0o n\u0103m t\u1edbi. D\u1ef1 ki\u1ebfn s\u1ebd c\u00f3 t\u1eeb 150-175 th\u00e0nh vi\u00ean l\u1ef1a ch\u1ecdn ti\u1ebfp t\u1ee5c tham gia ch\u01b0\u01a1ng tr\u00ecnh.<\/p>\n
Th\u1eddi gian \u0111\u0103ng k\u00fd m\u1edf h\u00e0ng n\u0103m cho Th\u1ecb tr\u01b0\u1eddng B\u1ea3o hi\u1ec3m Y t\u1ebf l\u00e0 t\u1eeb ng\u00e0y 1 th\u00e1ng 11 \u0111\u1ebfn ng\u00e0y 15 th\u00e1ng 12. Th\u1ecb tr\u01b0\u1eddng, m\u1ed9t ph\u1ea7n c\u1ee7a \u0110\u1ea1o lu\u1eadt Ch\u0103m s\u00f3c S\u1ee9c kh\u1ecfe Hoa K\u1ef3 (ACA), l\u00e0 n\u01a1i nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng c\u00f3 b\u1ea3o hi\u1ec3m \u0111\u0103ng k\u00fd tham gia m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh b\u1ea3o hi\u1ec3m y t\u1ebf cho n\u0103m ti\u1ebfp theo. \u0110\u1ed1i v\u1edbi h\u1ea7u h\u1ebft m\u1ecdi ng\u01b0\u1eddi, kho\u1ea3ng th\u1eddi gian 45 ng\u00e0y duy nh\u1ea5t n\u00e0y l\u00e0 th\u1eddi \u0111i\u1ec3m duy nh\u1ea5t trong n\u0103m h\u1ecd c\u00f3 th\u1ec3 \u0111\u0103ng k\u00fd.<\/p>","protected":false},"excerpt":{"rendered":"
(Austin, TX) \u2013 As the 2020 Open Enrollment Period opens Friday, Nov. 1, Central Health and Sendero Health Plans, its nonprofit health maintenance organization (HMO), are expanding a program that […]<\/p>\n","protected":false},"author":17,"featured_media":153575,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[4,70],"tags":[],"class_list":["post-153574","post","type-post","status-publish","format-standard","has-post-thumbnail","category-news","category-press-releases","entry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.centralhealth.net\/vi\/wp-json\/wp\/v2\/posts\/153574","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.centralhealth.net\/vi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.centralhealth.net\/vi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.centralhealth.net\/vi\/wp-json\/wp\/v2\/users\/17"}],"replies":[{"embeddable":true,"href":"https:\/\/www.centralhealth.net\/vi\/wp-json\/wp\/v2\/comments?post=153574"}],"version-history":[{"count":0,"href":"https:\/\/www.centralhealth.net\/vi\/wp-json\/wp\/v2\/posts\/153574\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.centralhealth.net\/vi\/wp-json\/wp\/v2\/media\/153575"}],"wp:attachment":[{"href":"https:\/\/www.centralhealth.net\/vi\/wp-json\/wp\/v2\/media?parent=153574"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.centralhealth.net\/vi\/wp-json\/wp\/v2\/categories?post=153574"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.centralhealth.net\/vi\/wp-json\/wp\/v2\/tags?post=153574"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}