Health services administration (41 - 50 of 102 items)
Medicare Drug and Nutrient Prices
HEHS-97-22R: Published: Oct 11, 1996. Publicly Released: Oct 11, 1996.
Pursuant to a congressional request, GAO reviewed the reasonableness of Medicare payments for outpatient drugs and liquid nutrients. GAO noted that: (1) the Health Care Financing Administration's (HCFA) policy reimburses outpatient drugs based on estimated acquisition costs or on the median, if applicable, of national average wholesale prices (AWP) for all generic sources; (2) Medicare contractors...
Veterans' Affairs and Military Health Care Issue Area Plan--Fiscal Years 1997-98
IAP-96-23: Published: Oct 1, 1996. Publicly Released: Oct 1, 1996.
GAO provided information on its Veterans' Affairs and Military Health Care issue area plan for fiscal years 1997 through 1998.GAO plans to identify: (1) more effective management controls to minimize fraud, waste, and abuse in Department of Veterans Affairs' (VA) and Department of Defense (DOD) health care systems; (2) ways to improve services to veterans and military dependents; (3) options for r...
Medicare: Private-Sector and Federal Efforts to Assess Health Care Quality
T-HEHS-96-215: Published: Sep 19, 1996. Publicly Released: Sep 19, 1996.
GAO discussed the Health Care Financing Administration's (HCFA) efforts to provide health care quality information to Medicare beneficiaries joining health maintenance organizations (HMO). GAO noted that: (1) corporate purchasers use accreditation and performance measurement monitoring to ensure that HMO furnish quality health care; (2) HCFA is starting to use similar methods to ensure HMO quality...
VHA's Management Improvement Initiative
HEHS-96-191R: Published: Aug 30, 1996. Publicly Released: Aug 30, 1996.
Pursuant to a congressional request, GAO examined the Department of Veterans Affairs' (VA) progress in implementing health care system management improvement initiatives. GAO noted that: (1) VA is reducing its centrally funded activities by $170 million, equipment purchases by $26 million, and other headquarters-managed accounts by $89 million; (2) VA has deferred most decisions pertaining to the...
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...
VA Health Care: Opportunities for Service Delivery Efficiencies Within Existing Resources
HEHS-96-121: Published: Jul 25, 1996. Publicly Released: Jul 25, 1996.
Pursuant to a congressional request, GAO provided information on the Department of Veterans Affairs' (VA) health care system, focusing on ways that VA could: (1) operate more efficiently; (2) reduce the resources needed to meet veterans' health care needs; and (3) reorganize its health care system and create efficiency incentives.GAO found that: (1) the VA health care system should be able to resp...
Medicaid: Waiver Program for Developmentally Disabled Is Promising But Poses Some Risks
HEHS-96-120: Published: Jul 22, 1996. Publicly Released: Jul 22, 1996.
Pursuant to a congressional request, GAO reviewed states' experiences in utilizing the Medicaid waiver program to provide care for developmentally disabled adults in alternative settings, focusing on: (1) expanding state use of the waiver program; (2) controlling long-term care costs for developmentally disabled individuals; and (3) the strengths and limitations in states' quality assurance approa...
Practice Guidelines: Managed Care Plans Customize Guidelines to Meet Local Interests
HEHS-96-95: Published: May 30, 1996. Publicly Released: Jul 1, 1996.
Pursuant to a congressional request, GAO reviewed how managed health plans make use of existing clinical practice guidelines.GAO found that: (1) clinical practice guidelines promote greater uniformity within physician networks, encourage improved efficiency and clinical decision-making, and eliminate unnecessary care; (2) several health plans have adopted clinical practice guidelines to control co...
Defense Health Care: New Managed Care Plan Progressing, but Cost and Performance Issues Remain
HEHS-96-128: Published: Jun 14, 1996. Publicly Released: Jun 14, 1996.
Pursuant to a congressional request, GAO reviewed the Department of Defense's (DOD) implementation of its TRICARE managed health care program, focusing on: (1) whether early implementation produced the expected results; (2) how early outcomes may affect costs; and (3) whether DOD is capturing data needed to manage and assess TRICARE performance.GAO found that: (1) early implementation of TRICARE h...
Medicare: Private Payer Strategies Suggest Options to Reduce Rapid Spending Growth
T-HEHS-96-138: Published: Apr 30, 1996. Publicly Released: Apr 30, 1996.
GAO discussed strategies to curb Medicare spending, which has grown by over 10 percent a year since 1989, twice the rate of the national economy. GAO noted that: (1) Medicare has not used tools used by private health care payers to manage and improve its utilization, reimbursement, and claims policies and procedures; (2) Medicare's smaller categories of services, which are typically less managed a...