Valera Health CEO: Payenera kukhala zolimbikitsa kulera gulu la SMI

Kupereka chithandizo chokwanira chaumoyo wamisala kwakhala kopambana komanso kovuta kwa Valera Health, yomwe ili ku Brooklyn, New York.

Kuchiza ana ndi odwala omwe ali ndi matenda amisala ochepa komanso owopsa (SMI) kumapangitsa kuti zinthu zikhale zosavuta kwa abwenzi a Valera Health Plan komanso anzawo azachipatala. Njirayi yakhala ikugwira ntchito mpaka pano, woyambitsa mgwirizano ndi CEO wa Valera Health Dr. Thomas Tsang anauza BHB.

“Ndikuganiza kuti ma inshuwaransi azaumoyo ndi mabungwe opereka chithandizo akufuna bwenzi lomwe lingathe kupereka phukusi lathunthu, osati yankho lachinthu chimodzi apa ndi chinthu chimodzi,” adatero Tsang.

Yakhazikitsidwa mu 2015, Valera Health anali mpaka posachedwapa wopereka chithandizo chamankhwala. Anatsegula ofesi yake yoyamba ku Manhattan ndipo ali “masiku oyambirira” kuti ayang’ane maofesi ena.

Mu Novembala 2021, Valera Health idalengeza kuti idatseka chiwongolero chosonkhanitsira ndalama cha Series A motsogozedwa ndi Windham Venture Partners chomwe chidakweza $ 15 miliyoni. Mpaka pano yapeza $26 miliyoni kuyambira pomwe idakhazikitsidwa.

Valera Health, yomwe imagwira ntchito pansi pa “chitsanzo chachinsinsi,” idzachitiranso odwala omwe amadziwonetsera okha ku kampaniyo komanso odwala omwe amagwirizana nawo amatchula kampaniyo.

Zomwe kampaniyo ikupereka zimaphatikizira chithandizo, kasamalidwe ka mankhwala, ndi kasamalidwe ka milandu.

Valera amagwiritsa ntchito othandizira pafupifupi 400 ndipo amapezeka kwa anthu 37 miliyoni kudzera mu mgwirizano wa Medicaid, Medicare, ndi Commercial Health Plan.

Njira yonse ya chisamaliro cha Valera Health

Njira yokhazikika imafuna kuti Valera Health achite zambiri kuposa kupereka thanzi labwino, makamaka kwa odwala omwe ali ndi SMI. Chochititsa chidwi n’chakuti, zimafuna kuti kampaniyo iwonetsetse bwino za thanzi la odwala ndikutsatira ndondomeko zamtundu wina.

Kawirikawiri, odwala omwe ali ndi SMI amakhala ndi thanzi labwino komanso zotsatira za chisamaliro kuposa omwe alibe.

Odwala omwe ali ndi thanzi labwino komanso matenda osachiritsika amakhala ndi ndalama zochulukirapo kawiri kapena katatu, malinga ndi lipoti la American Hospital Association. Kafukufuku wambiri wapeza kuti anthu omwe ali ndi SMI amakhala ndi nthawi yochepa. Kafukufuku wina anapeza kuti odwala SMI amamwalira zaka 10 mpaka 20 kale kuposa anthu ambiri.

Tsang adati Valera Health yatengera ndikutsata miyezo yapamwamba kwambiri monga momwe National Quality Assurance Board idanenera.

Miyezo iyi imafunikira Valera Health kuyeza kuchuluka kwa cholesterol ndi lipid kwa odwala omwe amathandizidwa ndi antipsychotics omwe amatha kukhala ndi zotsatira zoyipa za kuchuluka kwa cholesterol. Imatsatanso chiwopsezo cha matenda a shuga kwa odwala omwe atenga antipsychotics kwa miyezi ingapo.

Medicaid Challenge

Njira yowonjezera imapita kuzinthu zamagulu ndi zobwezera.

Tsang adati pali kusiyana kwakukulu pakati pa omwe amalipira, kuchuluka kwa ndalama zomwe amalipira komanso machitidwe azaumoyo a anthu.

“Malipiro a odwala omwe ali ndi SMI nthawi zina amakhala ofanana ndi a wodwala wofatsa,” adatero Tsang. “Payenera kukhala zolimbikitsa kusamalira anthu omwe ali pachiwopsezo chachikulu chifukwa ndizovuta kwambiri.”

Mavutowa ndi ovuta kwambiri pa mapulani a Medicaid. 35.7% yokha ya akatswiri amisala adalandira odwala atsopano omwe ali ndi chithandizo cha Medicaid, chiwerengero chotsika kwambiri pakati pa akatswiri onse. Chiwerengero chovomerezeka cha asing’anga chinali 70.8%, malinga ndi lipoti la 2019 la MACPAC.

Malinga ndi momwe wodwalayo amaonera, mapulani ambiri azachipatala a Medicaid amagwiritsa ntchito maukonde abodza omwe amakhala ngati cholepheretsa chisamaliro chaumoyo wamaganizidwe.

“Ndife amodzi mwa makampani ochepa omwe amavomereza odwala a Medicaid ndikuwongolera odwala a Medicaid,” adatero Tsang. “Ine ndinganene zimenezo [Medicaid] Njira yobwezera iyenera kuwongoleredwa. …

Monga wothandizira pa telehealth, kampaniyo imayendetsa malamulo osavuta komanso zofunikira zovomerezeka kumayiko angapo. Izi zimakhala zovuta kwambiri powerengera ndi mapulani azaumoyo.

Telehealth yokha imayang’anizana ndi malo osatsimikizika owongolera. Makampaniwa akusaka mafunso ambiri osathetsedwa a federal kuyambira paumodzi mpaka ngati Ryan Haight Act mu-munthu uphungu wofunikira ubwerera.

Komabe, kuyang’ana kwa mapulani azaumoyo, olemba anzawo ntchito, ndi magulu othandizira pakuphatikizira thanzi labwino m’chisamaliro kwapangitsa msika uwu wa Valera kukhwima.

Tsang anati: “Mnzathu aliyense wathanzi anatilandira ndi manja awiri n’kunena kuti, ‘Tikufuna, tikukufunani, ndipo odwala amakufunani.

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