Health care programs (71 - 80 of 195 items)
Childhood Obesity: Most Experts Identified Physical Activity and the Use of Best Practices as Key to Successful Programs
GAO-06-127R: Published: Oct 7, 2005. Publicly Released: Nov 7, 2005.
In the past 30 years, the number of obese children has increased throughout the United States, leading some policy makers to rank childhood obesity as a critical public health threat. The rate of childhood obesity has more than tripled for children between the ages of 6 and 11 and also increased for children of other ages over the same period. According to a 2005 Institute of Medicine (IOM) report...
U.S. Insular Areas: Multiple Factors Affect Federal Health Care Funding
GAO-06-75: Published: Oct 14, 2005. Publicly Released: Oct 17, 2005.
Five insular areas of the United States--American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands--benefit from federal health care financing and grant programs that help fund health care services to their over 4 million residents. However, notable differences exist in how the programs are funded or operate in the insular areas, such a...
Defense Health Care: Implementation Issues for New TRICARE Contracts and Regional Structure
GAO-05-773: Published: Jul 27, 2005. Publicly Released: Jul 27, 2005.
The Department of Defense (DOD) provides health care through TRICARE--a regionally structured program that uses civilian contractors to maintain provider networks to complement health care provided at military treatment facilities (MTF). In 2004, DOD implemented extensive changes to its TRICARE contracts and regional structure. A committee report accompanying the Ronald W. Reagan National Defense...
Health Centers And Rural Clinics: State and Federal Implementation Issues for Medicaid's New Payment System
GAO-05-452: Published: Jun 17, 2005. Publicly Released: Jun 17, 2005.
The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) established a prospective payment system (PPS) for Medicaid payments to Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC), giving providers a financial incentive to operate efficiently. BIPA requires that BIPA PPS rates be adjusted for inflation and changes in scope of services. States a...
Medicare Physician Fee Schedule: CMS Needs a Plan for Updating Practice Expense Component
GAO-05-60: Published: Dec 13, 2004. Publicly Released: Dec 13, 2004.
Medicare's payments for the costs physicians incur in operating their practices are based on two sets of estimates: total practice expenses and resource estimates for individual services. Total practice expense estimates were derived from American Medical Association (AMA) physician surveys, which the Centers for Medicare & Medicaid Services (CMS) refines with supplemental data submitted by medica...
Medicare Chemotherapy Payments: New Drug and Administration Fees Are Closer to Providers' Costs
GAO-05-142R: Published: Dec 1, 2004. Publicly Released: Dec 1, 2004.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) required the Secretary of the Department of Health and Human Services to change the payment rates for chemotherapy-related drugs and chemotherapy administration services. These changes followed reports that Medicare payments for chemotherapy-related drugs were much higher than physicians' costs to acquire them, and on...
Medicare Hospice Care: Modifications to Payment Methodology May Be Warranted
GAO-05-42: Published: Oct 15, 2004. Publicly Released: Oct 15, 2004.
The Medicare hospice benefit provides care to patients with a terminal illness. For each patient, hospices are paid a per diem rate corresponding to one of four payment categories, which are based on service intensity and location of care. Since implementation in 1983, the payment methodology and rates have not been evaluated. The Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 199...
Medicare: Appropriate Dispensing Fee Needed for Suppliers of Inhalation Therapy Drugs
GAO-05-72: Published: Oct 12, 2004. Publicly Released: Oct 12, 2004.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) revised the payment formula for most of the outpatient drugs, including inhalation therapy drugs, covered under Medicare part B. Under the revised formula, effective 2005, Medicare's payment is intended to be closer to acquisition costs. The Centers for Medicare & Medicaid Services (CMS), the agency that administers M...
Medicare Demonstration PPOs: Financial and Other Advantages for Plans, Few Advantages for Beneficiaries
GAO-04-960: Published: Sep 27, 2004. Publicly Released: Sep 27, 2004.
Preferred provider organizations (PPO) are more prevalent than other types of health plans in the private market, but, in 2003, only six PPOs contracted to serve Medicare beneficiaries in Medicare+Choice (M+C), Medicare's private health plan option. In recent years, the Centers for Medicare & Medicaid Services (CMS), the agency that administers Medicare, initiated two demonstrations that include a...
Medicare: Information Needed to Assess Adequacy of Rate-Setting Methodology for Payments for Hospital Outpatient Services
GAO-04-772: Published: Sep 17, 2004. Publicly Released: Sep 17, 2004.
Under the Medicare hospital outpatient prospective payment system (OPPS), hospitals receive a temporary additional payment for certain new drugs and devices while data on their costs are collected. In 2003, these payments expired for the first time for many drugs and devices. To incorporate these items into OPPS, the Centers for Medicare & Medicaid Services (CMS) used its rate-setting methodology...