Health insurance (11 - 20 of 139 items)
Medicare: Ownership Status of Inpatient Prospective Payment System Hospitals That Qualify for Payment Adjustments
GAO-13-667R: Published: Jun 27, 2013. Publicly Released: Jul 29, 2013.
GAO previously reported that, in 2012, upward payment adjustments affected the vast majority of hospitals paid under Medicare's inpatient prospective system (IPPS). (See GAO-13-334). For this report, GAO found that, of the 3,455 IPPS hospitals in the prior review, the proportion of hospitals qualifying for at least one of four categories of payment adjustments was higher among nonprofit and govern...
Medicare: Legislative Modifications Have Resulted in Payment Adjustments for Most Hospitals
GAO-13-334: Published: Apr 17, 2013. Publicly Released: May 16, 2013.
Over time, Congress has modified how Medicare reimburses certain hospitals under the inpatient prospective payment system (IPPS), which pays hospitals a flat fee per stay, set in advance, with different amounts for each type of condition. GAO identified numerous statutory provisions that individually increased Medicare payments to a subset of hospitals.Seven provisions enabled hospitals to be paid...
Defense Health Care: TRICARE Multiyear Surveys Indicate Problems with Access to Care for Nonenrolled Beneficiaries
GAO-13-364: Published: Apr 2, 2013. Publicly Released: Apr 2, 2013.
In its analysis of the 2008-2011 beneficiary survey data, GAO found that nearly one in three nonenrolled beneficiaries experienced problems finding a civilian provider who would accept TRICARE and that nonenrolled beneficiaries' access to civilian primary care and specialty care providers differed by type of location. Specifically, a higher percentage of nonenrolled beneficiaries in Prime Service...
Mental Health and Substance Use: Employers' Insurance Coverage Maintained or Enhanced Since Parity Act, but Effect of Coverage on Enrollees Varied
GAO-12-63: Published: Nov 30, 2011. Publicly Released: Nov 30, 2011.
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires that employers who offer health insurance coverage for mental health conditions and substance use disorders (MH/SU) provide coverage that is no more restrictive than that offered for medical and surgical conditions. Employers were required to comply with the law for coverage that began on o...
Medicaid and CHIP: Reports for Monitoring Children's Health Care Services Need Improvement
GAO-11-293R: Published: Apr 5, 2011. Publicly Released: Apr 5, 2011.
Medicaid and the Children's Health Insurance Program (CHIP)--two joint federal-state health care programs for low-income families and children--play a critical role in addressing the health care needs of children. In 2008, more than 36 million children in the United States received health care coverage through Medicaid or CHIP. Like all children, children covered by Medicaid and CHIP may have heal...
Private Health Insurance Coverage: Expert Views on Approaches to Encourage Voluntary Enrollment
GAO-11-392R: Published: Feb 25, 2011. Publicly Released: Mar 25, 2011.
To help expand health insurance coverage among the 50 million uninsured Americans, the Patient Protection and Affordable Care Act as amended (PPACA) mandates that individuals, subject to certain exceptions, obtain health insurance coverage or pay a financial penalty beginning in 2014--the "individual mandate". At the same time, PPACA generally requires insurers to accept all applicants, regardless...
Private Health Insurance: Data on Application and Coverage Denials
GAO-11-268: Published: Mar 16, 2011. Publicly Released: Mar 16, 2011.
The large percentage of Americans that rely on private health insurance for health care coverage could expand with enactment of the Patient Protection and Affordable Care Act (PPACA) of 2010. Until PPACA is fully implemented, some consumers seeking coverage can have their applications for enrollment denied, and those enrolled may face denials of coverage for specific medical services. PPACA requir...
Oral Health: Efforts Under Way to Improve Children's Access to Dental Services, but Sustained Attention Needed to Address Ongoing Concerns
GAO-11-96: Published: Nov 30, 2010. Publicly Released: Nov 30, 2010.
The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) required GAO to study children's access to dental care. GAO assessed (1) the extent to which dentists participate in Medicaid and the Children's Health Insurance Program (CHIP) and federal efforts to help families find participating dentists; (2) data on access for Medicaid and CHIP children in different states and in man...
Health Care Delivery: Features of Integrated Systems Support Patient Care Strategies and Access to Care, but Systems Face Challenges
GAO-11-49: Published: Nov 16, 2010. Publicly Released: Nov 16, 2010.
Health care delivery in the United States often lacks coordination and communication across providers and settings. This fragmentation can lead to poor quality of care, medical errors, and higher costs. Providers have formed integrated delivery systems (IDS) to improve efficiency, quality, and access. The Health Care Safety Net Act of 2008 directed GAO to report on IDSs that serve underserved popu...
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...