Health insurance (11 - 20 of 335 items)
Medicare: Payment Methods for Certain Cancer Hospitals Should Be Revised to Promote Efficiency
GAO-15-199: Published: Feb 20, 2015. Publicly Released: Mar 23, 2015.
Unlike beneficiaries seen at teaching hospitals paid under Medicare's prospective payment systems (PPS) in 2012, nearly all beneficiaries seen at PPS-exempt cancer hospitals (PCH)—a group of 11 facilities having met certain statutory criteria—had a diagnosis of cancer. However, the health status of Medicare beneficiaries with cancer who were treated at PCHs and PPS teaching hospitals was not m...
Healthcare.gov: CMS Has Taken Steps to Address Problems, but Needs to Further Implement Systems Development Best Practices
GAO-15-238: Published: Mar 4, 2015. Publicly Released: Mar 4, 2015.
Several problems with the initial development and deployment of Healthcare.gov and its supporting systems led to consumers encountering widespread performance issues when trying to create accounts and enroll in health plans:Inadequate capacity planning: The Centers for Medicare & Medicaid Services (CMS) did not plan for adequate capacity to support Healthcare.gov and its supporting systems.Softwar...
Medicaid: Federal Funds Aid Eligibility IT System Changes, but Implementation Challenges Persist
GAO-15-169: Published: Dec 12, 2014. Publicly Released: Dec 12, 2014.
Reported spending across all 50 states and the District of Columbia totaled more than $1.8 billion for Medicaid 90/10 funds—funds for eligibility information technology (IT) system changes—through September 30, 2014. Spending has grown steadily, with the most significant increases over the most recent quarters. According to the Centers for Medicare & Medicaid Services (CMS), 34 states used 90/...
Private Health Insurance: Concentration of Enrollees among Individual, Small Group, and Large Group Insurers from 2010 through 2013
GAO-15-101R: Published: Dec 1, 2014. Publicly Released: Dec 1, 2014.
The Patient Protection and Affordable Care Act (PPACA) requires GAO to study competition and market concentration in the health insurance market. For this study, we examined individual, small group, and large group health insurance markets prior to the implementation of key PPACA provisions that went into effect in 2014 and that could affect competition and market concentration among health insure...
Small Business Health Insurance Exchanges: Low Initial Enrollment Likely due to Multiple, Evolving Factors
GAO-15-58: Published: Nov 13, 2014. Publicly Released: Nov 13, 2014.
Though all of the Small Business Health Options Programs (SHOPs) required by the Patient Protection and Affordable Care Act were operational, many features were not yet available and enrollment was low as of June 2014. According to the Centers for Medicare & Medicaid Services (CMS), the agency that oversees the SHOPs, all 33 of the SHOPs run by CMS (federally facilitated, or FF-SHOPs) and 14 of th...
Private Health Insurance: The Range of Average Annual Premiums in the Small Group Market by State in Early 2013
GAO-14-524R: Published: May 28, 2014. Publicly Released: Jun 24, 2014.
GAO reported the range of average premiums for health insurance products sold to small employers in the small group market of each of the 50 states and the District of Columbia during the first quarter of 2013. The average premiums reflected information from data submitted by insurers to the Center for Consumer Information and Insurance Oversight (CCIIO) within the Department of Health and Human S...
Private Health Insurance: The Range of Base Premiums for Individuals Age 19 and 64 in the Individual Market by State in January 2013
GAO-14-263R: Published: Jan 31, 2014. Publicly Released: Feb 4, 2014.
GAO reported the range of base premiums prior to underwriting for individual market health insurance plans as displayed on the HealthCare.gov Plan Finder in January 2013. The base premiums were for individuals aged 19 and 64 in each of the 50 states and the District of Columbia. The base premiums reflected information from data submitted by insurers to the Center for Consumer Information and Insur...
Medicare: Continuous Insurance before Enrollment Associated with Better Health and Lower Program Spending
GAO-14-53: Published: Dec 17, 2013. Publicly Released: Jan 16, 2014.
Beneficiaries with continuous health insurance coverage for approximately 6 years before enrolling in Medicare were more likely than those without prior continuous insurance to report being in good health or better during the first 6 years in Medicare. In particular, having prior continuous insurance raised the predicted probability that a beneficiary reported being in good health or better by nea...
Medicare Information Technology: Centers for Medicare and Medicaid Services Needs to Pursue a Solution for Removing Social Security Numbers from Cards
GAO-13-761: Published: Sep 10, 2013. Publicly Released: Oct 17, 2013.
The Centers for Medicare and Medicaid Services (CMS)--which is the agency within the Department of Health and Human Services (HHS) responsible for administering Medicare--has not taken needed steps, such as designating a business owner and establishing a business case for an information technology (IT) project, that would result in selecting and implementing a technical solution for removing Socia...
Indian Health Service: Most American Indians and Alaska Natives Potentially Eligible for Expanded Health Coverage, but Action Needed to Increase Enrollment
GAO-13-553: Published: Sep 5, 2013. Publicly Released: Sep 5, 2013.
GAO estimates, on the basis of recent U.S. Census Bureau data, that most American Indians and Alaska Natives will be potentially eligible for either expanded or new coverage options created by the Patient Protection and Affordable Care Act (PPACA). These options include expanded eligibility for Medicaid--the federal-state program for certain low-income individuals--and eligibility for the Health I...