Cost analysis (11 - 20 of 100 items)
Medicare Advantage: Enrollment Increased from 2010 to 2011 while Premiums Decreased and Benefit Packages Were Stable
GAO-12-93: Published: Oct 31, 2011. Publicly Released: Nov 30, 2011.
Enrollment and spending in Medicare Advantage (MA) plans--the private plan alternative to the Medicare fee-for- service (FFS) program--have more than doubled since 2004. MA plans generally receive larger payments from Medicare than what these plans would require to provide the original Medicare FFS benefit package. Plans must use this additional money to reduce cost sharing, reduce premiums, and o...
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...
Private Health Insurance: Early Experiences Implementing New Medical Loss Ratio Requirements
GAO-11-711: Published: Jul 29, 2011. Publicly Released: Aug 29, 2011.
To help ensure that Americans receive value for their premium dollars, the Patient Protection and Affordable Care Act (PPACA) established minimum "medical loss ratio" (MLR) standards for health insurers. The MLR is a basic financial indicator, traditionally referring to the percentage of premiums spent on medical claims. The PPACA MLR is defined differently from the traditional MLR. Beginning in 2...
Department of Veterans Affairs: Issues Related to Real Property Realignment and Future Health Care Costs
GAO-11-877T: Published: Jul 27, 2011. Publicly Released: Jul 27, 2011.
This testimony discusses lifetime costs of supporting the newest generation of veterans. The Department of Veterans Affairs (VA) operates one of the largest health care delivery systems in the nation, providing care to a diverse population of veterans. VA operates about 150 hospitals, 130 nursing homes, and 820 outpatient clinics through 21 regional health care networks called Veterans Integrated...
Medicare Part D: Changes in Utilization Similar for Randomly Reassigned and Other Low-Income Subsidy Beneficiaries
GAO-11-546R: Published: Jun 22, 2011. Publicly Released: Jul 22, 2011.
To help defray out-of-pocket prescription drug costs for limited or low-income Medicare beneficiaries, the Medicare Part D outpatient prescription drug program offers a low-income subsidy (LIS) for eligible beneficiaries. In 2010, about 9.4 million beneficiaries received the LIS--about 40 percent of the approximately 23 million Medicare Part D beneficiaries in that year. Most of the LIS beneficiar...
Global Health: Trends in U.S. Spending for Global HIV/AIDS and Other Health Assistance in Fiscal Years 2001-2008
GAO-11-64: Published: Oct 8, 2010. Publicly Released: Oct 8, 2010.
U.S. funding for global HIV/AIDS and other health-related programs rose significantly from 2001 to 2008. The President's Emergency Plan for AIDS Relief (PEPFAR), reauthorized in 2008 at $48 billion through 2013, has made significant investments in support of prevention of HIV/AIDS as well as care and treatment for those affected by the disease in 31 partner countries and 3 regions. In May 2009, th...
Consumer-Directed Health Plans: Health Status, Spending, and Utilization of Enrollees in Plans Based on Health Reimbursement Arrangements
GAO-10-616: Published: Jul 16, 2010. Publicly Released: Aug 16, 2010.
Consumer-directed health plans (CDHP) combine a high-deductible health plan with a tax-advantaged account, such as a health reimbursement arrangement (HRA), that enrollees can use to pay for health care expenses. In an effort to restrain cost growth, several employers, including the federal government through its Office of Personnel Management (OPM), have offered HRAs for several years. For enroll...
State and Local Governments: Fiscal Pressures Could Have Implications for Future Delivery of Intergovernmental Programs
GAO-10-899: Published: Jul 30, 2010. Publicly Released: Aug 13, 2010.
State and local governments work in partnership with the federal government to implement numerous intergovernmental programs. Fiscal pressures for state and local governments may exist when spending is expected to outpace revenues for the long term. GAO was asked to examine (1) the long-term fiscal pressures facing state and local governments and historical spending and revenue trends, (2) spendin...
Medicare Advantage: Relationship between Benefit Package Designs and Plans' Average Beneficiary Health Status
GAO-10-403: Published: Apr 30, 2010. Publicly Released: Jun 1, 2010.
Nearly 11 million Medicare beneficiaries are enrolled in Medicare Advantage (MA), Medicare's private health insurance option. Benefits vary by MA plan and may include coverage for services not available in traditional Medicare. To ensure MA plan benefit package designs do not discriminate against beneficiaries in poor health with high expected health care costs, the Centers for Medicare & Medicaid...
Medicare Part D: Spending, Beneficiary Out-of-Pocket Costs, and Efforts to Obtain Price Concessions for Certain High-Cost Drugs
GAO-10-529T: Published: Mar 17, 2010. Publicly Released: Mar 17, 2010.
The Centers for Medicare & Medicaid Services (CMS) allows Part D plans to utilize different tiers with different levels of cost sharing as a way of managing drug utilization and spending. One such tier, the specialty tier, is designed for high-cost drugs whose prices exceed a certain threshold set by CMS. Beneficiaries who use these drugs typically face higher out-of-pocket costs than beneficiarie...