Managed health care (61 - 70 of 157 items)
Medicaid Managed Care: Challenges in Implementing Safeguards for Children With Special Needs
HEHS-00-37: Published: Mar 3, 2000. Publicly Released: Apr 3, 2000.
Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) and the states' efforts to implement safeguards to protect children with disabilities who are enrolled in Medicaid managed care programs, focusing on the: (1) implications of the Balanced Budget Act of 1997 (BBA) provisions defining this population; (2) number of states enrolling children with speci...
Health Care Access: Programs for Underserved Populations Could Be Improved
T-HEHS-00-81: Published: Mar 23, 2000. Publicly Released: Mar 23, 2000.
Pursuant to a congressional request, GAO discussed the effectiveness of the Health Resources and Services Administration's (HRSA) two safety-net programs--the Community and Migrant Health Center program and the National Health Service Corps--to improve access to medically underserved populations.GAO noted that: (1) both the health centers and the Corps are important safety-net providers to the nat...
Prescription Drug Benefits: Applying Private Sector Management Methods to Medicare
T-HEHS-00-84: Published: Mar 22, 2000. Publicly Released: Mar 22, 2000.
Pursuant to a congressional request, GAO discussed issues related to a potential Medicare outpatient prescription drug benefit, focusing on: (1) the factors contributing to the rise in prescription drug spending and the impact of the rise in spending on Medicare beneficiaries; (2) the methods private insurers have developed to manage these rising costs; and (3) whether and how Medicare can adapt t...
Medicare Reform: Leading Proposals Lay Groundwork, While Design Decisions Lie Ahead
T-HEHS/AIMD-00-103: Published: Feb 24, 2000. Publicly Released: Feb 24, 2000.
Pursuant to a congressional request, GAO discussed two leading proposals on Medicare reform: (1) the President's Plan to Modernize and Strengthen Medicare for the 21st Century; and (2) S. 1895, entitled the Medicare Preservation and Improvement Act of 1999, which is commonly referred to as the Breax-Frist proposal.GAO noted that: (1) the elements of restructuring of Medicare as proposed by the Pre...
Medicare: Program Reform and Modernization Are Needed But Entail Considerable Challenges
T-HEHS/AIMD-00-77: Published: Feb 8, 2000. Publicly Released: Feb 8, 2000.
Pursuant to a congressional request, GAO discussed efforts to reform the administration, structure, and financing of the Medicare Program.GAO noted that: (1) in addition to its sizable financial imbalance, Medicare is outmoded from a programmatic perspective; (2) to address the need for an updated benefit package and adequate tools to moderate program spending, proposals have been advanced that in...
Medicaid Managed Care: Four States' Experiences With Mental Health Carveout Programs
HEHS-99-118: Published: Sep 17, 1999. Publicly Released: Sep 17, 1999.
Pursuant to a congressional request, GAO provided information on how states design and monitor Medicaid mental health programs, and how, at the federal level, the Health Care Financing Administration (HCFA) exercises its oversight of the Medicaid program, focusing on: (1) the extent of beneficiary choice in capitated mental health carveouts, the range of covered mental health services, and access...
Medicare Managed Care: Better Risk Adjustment Expected to Reduce Excess Payments Overall While Making Them Fairer to Individual Plans
T-HEHS-99-72: Published: Feb 25, 1999. Publicly Released: Feb 25, 1999.
Pursuant to a congressional request, GAO discussed the adjustment of Medicare's payments to managed care plans in the Medicare Choice program, focusing on the: (1) importance of improving the current risk adjustment method; (2) implications of rate-setting changes implemented in 1998; and (3) the advantages and drawbacks of the Health Care Financing Administration's (HCFA) proposed new interim ris...
Health Insurance for Children: Private Individual Coverage Available, but Choices Can Be Limited and Costs Vary
HEHS-98-201: Published: Aug 5, 1998. Publicly Released: Aug 13, 1998.
Pursuant to a congressional request, GAO reviewed the availability of private sector health coverage for children in the individual insurance market, focusing on: (1) the availability and characteristics of private health insurance products that can be purchased only for a child and how these products differ from other individual private insurance products; (2) the costs of these child-only produc...
Federal Health Programs: Comparison of Medicare, the Federal Employees Health Benefits Program, Medicaid, Veterans' Health Services, Department of Defense Health Services, and Indian Health Services
HEHS-98-231R: Published: Aug 7, 1998. Publicly Released: Aug 7, 1998.
GAO compared the Medicare program with five other federal health programs: the Federal Employees Health Benefits Program (FEHBP); the Medicaid and Department of Veterans' Affairs (VA) health programs; the Department of Defense's (DOD) TRICARE health program; and the Indian Health Service (IHS). GAO also compared key features of these programs, including: (1) administrative structures, including th...
Health Services Quality and Public Health Issue Area Plan: Fiscal Years 1999-2000
IAP-98-14: Published: Aug 1, 1998. Publicly Released: Aug 1, 1998.
GAO provided information on its Health Services Quality and Public Health issue area plan for fiscal years 1999 and 2000.GAO plans to: (1) determine whether the public health service agencies are ensuring the public's health and safety efficiently and effectively; (2) identify opportunities for improving the quality of health care under fee-for-service and managed care payment arrangements; (3) id...