Health insurance cost control (61 - 70 of 122 items)
Health Financing and Systems Issues Issue Area Plan--Fiscal Years 1998-2000
IAP-97-13: Published: Jul 1, 1997. Publicly Released: Jul 1, 1997.
GAO provided information on its Health Financing and Systems issue area plan for fiscal years 1998 to 2000.GAO plans to examine: (1) actions to improve the management and financial integrity of the Medicare and Medicaid programs; (2) new strategies for paying for Medicare and Medicaid services that promote cost containment while preserving quality and access; (3) how financing arrangements affect...
Medicare HMOs: Setting Payment Rates Through Competitive Bidding
HEHS-97-154R: Published: Jun 12, 1997. Publicly Released: Jun 12, 1997.
GAO reviewed the Health Care Financing Administration's (HCFA) proposed use of competitive bidding as an alternative method for setting Medicare health maintenance organization (HMO) payment rates, focusing on: (1) the potential advantages of competitive bidding in the Medicare HMO program; (2) the main features of HCFA's planned competitive bidding demonstration in Denver; and (3) HMO's key objec...
Comments on H.R. 4229: A Proposal for a Home Health Prospective Payment System
HEHS-97-144R: Published: May 28, 1997. Publicly Released: Jun 4, 1997.
Pursuant to a congressional request, GAO reviewed H.R. 4229, introduced in the 104th Congress, which would require the Health Care Financing Administration (HCFA) to establish, after congressional approval, a prospective payment system (PPS) for Medicare home health care 4 years after enactment that would pay fixed rates for episodes of care.GAO noted that: (1) home health agencies (HHA) would be...
Medicare Managed Care: HMO Rates, Other Factors Create Uneven Availability of Benefits
T-HEHS-97-133: Published: May 19, 1997. Publicly Released: May 19, 1997.
GAO discussed aspects of Medicare managed care, including greater choice and equity across the program, focusing on: (1) the link between counties' capitation rates and Medicare's spending on fee-for-service care; (2) factors affecting the availability of plans in a given area, the level of premiums charged, and the benefit packages offered; and (3) modifications to Medicare's current payment meth...
Medicare HMOs: HCFA Can Promptly Eliminate Hundreds of Millions in Excess Payments
HEHS-97-16: Published: Apr 25, 1997. Publicly Released: May 13, 1997.
Pursuant to a congressional request, GAO provided information on Medicare's rate-setting method for paying risk contract health maintenance organizations (HMO), focusing on: (1) the conditions under which Medicare's method can yield payment rates that are too high; and (2) a practical improvement to Medicare's method directed at the problems fostering excess payments.GAO noted that: (1) contrary t...
Medicare HMO Enrollment: Area Differences Affected by Factors Other Than Payment Rates
HEHS-97-37: Published: May 2, 1997. Publicly Released: May 2, 1997.
Pursuant to a congressional request, GAO reviewed the factors affecting Medicare risk health maintenance organization (HMO) enrollment, focusing on: (1) the patterns in HMO enrollment and Medicare payment rates; (2) selected geographical areas with higher enrollment, lower payment rates and areas with lower enrollment, higher payment rates; and (3) how the presence or absence of certain factors co...
Medicare Post-Acute Care: Cost Growth and Proposals to Manage It Through Prospective Payment and Other Controls
T-HEHS-97-106: Published: Apr 9, 1997. Publicly Released: Apr 9, 1997.
GAO discussed Medicare's skilled nursing facility (SNF), home health care, and inpatient rehabilitation benefits and the administration's forthcoming legislative proposals related to them.GAO noted that: (1) Medicare's SNF costs have grown primarily because a larger portion of beneficiaries use SNFs than in the past and because of a large increase in the provision of ancillary services; (2) for ho...
Medicaid: Graduate Medical Education Payments
HEHS-97-77R: Published: Mar 3, 1997. Publicly Released: Apr 2, 1997.
Pursuant to a congressional request, GAO provided information on: (1) existing studies that estimate overall Medicaid expenditures for graduate medical education (GME); (2) the amount of Medicaid GME payments for the 10 states with the largest overall Medicaid expenditures, and the basis for determining these payments; and (3) how Medicaid and Medicare coordinate their GME payments to avoid duplic...
Employment-Based Health Insurance: Costs Increase and Family Coverage Decreases
HEHS-97-35: Published: Feb 24, 1997. Publicly Released: Mar 21, 1997.
Pursuant to a congressional request, GAO provided information on the decline in employment-based health insurance, focusing on: (1) recent trends in employment-based private health insurance, particularly for family coverage; (2) any corresponding changes in the number of adults and children with private insurance coverage as dependents; and (3) the potential effect of these changes, if any, on pu...
Medicaid: Recent Spending Experience and the Administration's Proposed Program Reform
T-HEHS-97-94: Published: Mar 11, 1997. Publicly Released: Mar 11, 1997.
GAO discussed recent Medicaid spending trends and their potential implications for future outlays, focusing on: (1) key factors that explain the Medicaid 3.3-percent growth rate in fiscal year 1996; and (2) the administration's proposal to contain Medicaid cost growth through decreases in disproportionate share hospital (DSH) payments and per capita caps, and to increase state flexibility.GAO note...