Cost control (1 - 10 of 119 items)
Medicare: Payment Methods for Certain Cancer Hospitals Should Be Revised to Promote Efficiency
GAO-15-199: Published: Feb 20, 2015. Publicly Released: Mar 23, 2015.
Unlike beneficiaries seen at teaching hospitals paid under Medicare's prospective payment systems (PPS) in 2012, nearly all beneficiaries seen at PPS-exempt cancer hospitals (PCH)—a group of 11 facilities having met certain statutory criteria—had a diagnosis of cancer. However, the health status of Medicare beneficiaries with cancer who were treated at PCHs and PPS teaching hospitals was not m...
Medicaid Demonstrations: HHS's Approval Process for Arkansas's Medicaid Expansion Waiver Raises Cost Concerns
GAO-14-689R: Published: Aug 8, 2014. Publicly Released: Sep 8, 2014.
In approving Arkansas’s Medicaid Section 1115 demonstration, the Department of Health and Human Services (HHS) gave the state the authority to test whether providing premium assistance to purchase private coverage offered on the health insurance exchange will improve access to care for individuals newly eligible for Medicaid as a result of the Patient Protection and Affordable Care Act (PPACA).I...
Healthcare.gov: Ineffective Planning and Oversight Practices Underscore the Need for Improved Contract Management
GAO-14-694: Published: Jul 30, 2014. Publicly Released: Jul 30, 2014.
The Centers for Medicare & Medicaid Services (CMS) undertook the development of Healthcare.gov and its related systems without effective planning or oversight practices, despite facing a number of challenges that increased both the level of risk and the need for effective oversight. CMS officials explained that the task of developing a first-of-its-kind federal marketplace was a complex effort wit...
Military Health System: Sustained Senior Leadership Needed to Fully Develop Plans for Achieving Cost Savings
GAO-14-396T: Published: Feb 26, 2014. Publicly Released: Feb 26, 2014.
Department of Defense (DOD) senior leadership has demonstrated a commitment to oversee implementation of its military health system’s (MHS) reform and has taken a number of actions to enhance the reform efforts. For example, in March 2013, DOD chartered the MHS Governance Transition Organization to provide oversight, management, and support for the implementation. This entity is chartered to exi...
Defense Health Care Reform: Additional Implementation Details Would Increase Transparency of DOD's Plans and Enhance Accountability
GAO-14-49: Published: Nov 6, 2013. Publicly Released: Nov 6, 2013.
GAO determined that the Department of Defenses (DOD) March and June 2013 submissions on establishing a Defense Health Agency (DHA) to reform the governance of the Military Health System (MHS) met three statutory requirements to include information on goals, performance measures, and staffing; partially met one requirement to include information on timelines; and was not required to include i...
Medicare: Ownership Status of Inpatient Prospective Payment System Hospitals That Qualify for Payment Adjustments
GAO-13-667R: Published: Jun 27, 2013. Publicly Released: Jul 29, 2013.
GAO previously reported that, in 2012, upward payment adjustments affected the vast majority of hospitals paid under Medicare's inpatient prospective system (IPPS). (See GAO-13-334). For this report, GAO found that, of the 3,455 IPPS hospitals in the prior review, the proportion of hospitals qualifying for at least one of four categories of payment adjustments was higher among nonprofit and govern...
Medicare: Legislative Modifications Have Resulted in Payment Adjustments for Most Hospitals
GAO-13-334: Published: Apr 17, 2013. Publicly Released: May 16, 2013.
Over time, Congress has modified how Medicare reimburses certain hospitals under the inpatient prospective payment system (IPPS), which pays hospitals a flat fee per stay, set in advance, with different amounts for each type of condition. GAO identified numerous statutory provisions that individually increased Medicare payments to a subset of hospitals.Seven provisions enabled hospitals to be paid...
Patient Protection and Affordable Care Act: Effect on Long-Term Federal Budget Outlook Largely Depends on Whether Cost Containment Sustained
GAO-13-281: Published: Jan 31, 2013. Publicly Released: Feb 26, 2013.
The effect of the Patient Protection and Affordable Care Act (PPACA), enacted in March 2010, on the long-term fiscal outlook depends largely on whether elements in PPACA designed to control cost growth are sustained. There was notable improvement in the longer-term outlook after the enactment of PPACA under GAO's Fall 2010 Baseline Extended simulation, which assumes both the expansion of health ca...
Preventive Health Activities: Available Information on Federal Spending, Cost Savings, and International Comparisons Has Limitations
GAO-13-49: Published: Dec 6, 2012. Publicly Released: Jan 7, 2013.
The Departments of Health and Human Services (HHS), Veterans Affairs (VA), and Defense (DOD) administer programs that include preventive health activities such as health screenings and education campaigns, but the departments reported that they do not track department-wide spending on these activities. Departments reported that determining such spending is challenging because these activities can...
Private Health Insurance: Implementation of the Early Retiree Reinsurance Program
GAO-11-875R: Published: Sep 30, 2011. Publicly Released: Oct 31, 2011.
During the last decade the number of large employers offering health benefits to retirees--including early retirees not eligible for Medicare--has declined. Among all large firms that offered health benefits to active employees from 2001 to 2010, the percentage that offered health benefits to retirees decreased from 39 percent in 2001 to 28 percent in 2010. According to the Agency for Healthcare R...