Health insurance cost control (21 - 30 of 102 items)
Prescription Drug Pricing: Implications for Retail Pharmacies
T-HEHS-96-216: Published: Sep 19, 1996. Publicly Released: Sep 19, 1996.
GAO discussed the implications of prescription drug pricing for retail pharmacies, focusing on the: (1) changes in the process of getting prescription drugs from manufacturers to patients; and (2) consequences for and response of retail pharmacies to these changes. GAO noted that: (1) health insurers have used their consolidated buying power to obtain drug discounts not available to retail pharmac...
Health Financing and Systems Issue Area: Active Assignments
AA-96-15(4): Published: Sep 3, 1996. Publicly Released: Sep 3, 1996.
GAO provided information on its active assignments in the Health Financing and Systems issue area as of September 3, 1996...
Blue Cross FEHBP Pharmacy Benefits
HEHS-96-182R: Published: Jul 19, 1996. Publicly Released: Aug 9, 1996.
Pursuant to a congressional request, GAO provided information on the Blue Cross and Blue Shield Association's two pharmacy benefit managers and the services they provide to federal employee benefit plans. GAO noted that: (1) to control drug costs, the Association is requiring Medicare Part B participants to pay the standard copayment for drugs bought at participating retail pharmacies, but it is w...
Health Insurance: Coverage of Autologous Bone Marrow Transplantation for Breast Cancer
HEHS-96-83: Published: Apr 24, 1996. Publicly Released: May 28, 1996.
Pursuant to a congressional request, GAO reviewed insurance coverage of autologous bone marrow transplantation (ABMT) for breast cancer, focusing on: (1) the factors insurers consider when deciding whether to cover treatment; (2) the effectiveness of the treatment; and (3) the consequences of the increased use and insurance coverage of the treatment while it is still in clinical trials.GAO found t...
Medicare Managed Care: Enrollment Growth Underscores Need to Revamp HMO Payment Methods
T-HEHS-95-207: Published: Jul 12, 1995. Publicly Released: Jul 12, 1995.
Pursuant to a congressional request, GAO discussed the: (1) recent trends in Medicare beneficiary enrollment in health maintenance organizations (HMO); (2) obstacles that are preventing Medicare from realizing potential savings from HMO; (3) strategies that will enable Medicare to realize HMO savings; and (4) Health Care Financing Administration's (HCFA) efforts to test HMO payment reforms. GAO no...
Medicare: Rapid Spending Growth Calls for More Prudent Purchasing
T-HEHS-95-193: Published: Jun 28, 1995. Publicly Released: Jun 28, 1995.
GAO discussed ways in which the Medicare program could avoid excessive or unnecessary spending. GAO noted that: (1) although private payers increasingly use aggressive cost-management strategies to control health care costs, the Health Care Financing Administration (HCFA) often finds it difficult to use these strategies to control health care costs, since payment policies are established at the co...
High Risk Series: Medicare Claims
HR-95-8: Published: Feb 1, 1995. Publicly Released: Feb 1, 1995.
GAO provided information on the Health Care Financing Administration's (HCFA) efforts to implement regulatory and administrative procedures to deal with fraud and abuse in the Medicare Program.GAO found that: (1) HCFA has established a requirement that raises the standards for contractor performance regarding analyses of payment data; (2) HCFA has awarded a contract for the development of a nation...
German Health Reforms: Changes Result in Lower Health Costs in 1993
HEHS-95-27: Published: Dec 16, 1994. Publicly Released: Dec 16, 1994.
GAO reviewed the German health care system, focusing on the: (1) effects of nonnegotiable budgets on health care cost and access to care; and (2) status of some of the structural changes intended to control costs over the longer term.GAO found that: (1) during 1993, the German health care sectors generally succeeded in controlling the growth of health care costs, with outlays per member falling mo...
Health Care Reform: Considerations for Risk Adjustment Under Community Rating
HEHS-94-173: Published: Sep 22, 1994. Publicly Released: Oct 25, 1994.
Pursuant to a congressional request, GAO reviewed various issues regarding risk adjustment under health care reform, focusing on: (1) how the government's past experience with risk adjustment is relevant to recent health care reform initiatives; and (2) the features of health care reform that could affect risk adjustment and selection bias.GAO found that: (1) the goal of community rating may be co...
Medicare: Changes to HMO Rate Setting Method Are Needed to Reduce Program Costs
HEHS-94-119: Published: Sep 2, 1994. Publicly Released: Sep 2, 1994.
Pursuant to a legislative requirement, GAO reviewed: (1) Medicare's rate setting methodology for health maintenance organizations (HMO); and (2) the ability of the Medicare risk contract program to achieve cost savings.GAO found that: (1) the Medicare risk contract program has not reduced Medicare costs because the Health Care Financing Administration's (HCFA) rate setting methodology and administ...