Health care costs (31 - 40 of 167 items)
Medicaid Outpatient Drugs: Estimated 2007 Federal Upper Limits for Reimbursement Compared with Retail Pharmacy Acquisition Costs
GAO-07-239R: Published: Dec 22, 2006. Publicly Released: Jan 22, 2007.
Spending on outpatient prescription drugs in Medicaid--the joint federal-state program that finances medical services for certain low-income adults and children--has accounted for a substantial and growing share of Medicaid expenditures. Medicaid's total spending on outpatient prescription drugs grew from $4.6 billion in fiscal year 1990 to $40 billion in fiscal year 2004--or from 7.0 to 14.2 perc...
Medicaid: Strategies to Help States Address Increased Expenditures during Economic Downturns
GAO-07-97: Published: Oct 18, 2006. Publicly Released: Nov 15, 2006.
During economic downturns, states may struggle to finance Medicaid, a federal-state health financing program for certain low-income individuals. States receive federal matching funds for their Medicaid programs according to a statutory formula based on each state's per capita income (PCI) in relation to national PCI. The number of individuals eligible for Medicaid can increase during downturns as...
Medicaid Third-Party Liability: Federal Guidance Needed to Help States Address Continuing Problems
GAO-06-862: Published: Sep 15, 2006. Publicly Released: Oct 17, 2006.
Medicaid, jointly funded by the federal government and the states, finances health care for about 56 million low-income people at an estimated total cost of about $298 billion in fiscal year 2004. Congress intended Medicaid to be the payer of last resort: if Medicaid beneficiaries have another source of health care coverage--such as private health insurance or a health plan purchased individually...
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...
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 Dialysis Facilities: Beneficiary Access Stable and Problems in Payment System Being Addressed
GAO-04-450: Published: Jun 25, 2004. Publicly Released: Jun 25, 2004.
Medicare covers about 90 percent of patients with end-stage renal disease (ESRD), the permanent loss of kidney function. Most ESRD patients receive regular hemodialysis treatments, a process that removes toxins from the blood, at a dialysis facility. A small percentage dialyzes-at home. From 1991 through 2001, the ESRD patient population more than doubled, from about 201,000 to 406,000. As the nee...
Undocumented Aliens: Questions Persist about Their Impact on Hospitals' Uncompensated Care Costs
GAO-04-472: Published: May 21, 2004. Publicly Released: May 28, 2004.
About 7 million undocumented aliens lived in the United States in 2000, according to Immigration and Naturalization Service estimates. Hospitals in states where many of them live report that treating them can be a financial burden. GAO was asked to examine the relationship between treating undocumented aliens and hospitals' costs not paid by patients or insurance. GAO was also asked to examine fed...
Medicaid: Intergovernmental Transfers Have Facilitated State Financing Schemes
GAO-04-574T: Published: Mar 18, 2004. Publicly Released: Mar 18, 2004.
Medicaid, the federal-state health financing program for many of the nation's most vulnerable populations, finances health care for an estimated 53 million lowincome Americans, at a cost of $244 billion in 2002. Congress structured Medicaid as a shared fiduciary responsibility of the federal government and the states, with the federal share of each state's Medicaid payments determined by a formula...
Medicaid Nursing Home Payments: States' Payment Rates Largely Unaffected by Recent Fiscal Pressures
GAO-04-143: Published: Oct 17, 2003. Publicly Released: Nov 26, 2003.
Almost half of all Americans over the age of 65 will rely on nursing home care at some point in their lives, and two in three nursing home residents have their care covered at least in part by Medicaid. Under Medicaid, states set nursing home payment rates and the federal government reimburses a share of state spending. According to the most recently available data, Medicaid nursing home expenditu...
Prescription Drug Discount Cards: Savings Depend on Pharmacy and Type of Card Used
GAO-03-912: Published: Sep 3, 2003. Publicly Released: Sep 8, 2003.
While prescription drugs have become an increasingly important part of health care for the elderly, more than one-quarter of all Medicare beneficiaries have no prescription drug coverage. Over the past decade, private companies and not-for-profit organizations have sponsored prescription drug discount cards that offer discounts from the prices the elderly would otherwise have to pay for their pres...