Medical services rates (41 - 50 of 200 items)
Medicare Physician Payments: Information on Spending Trends and Targets
GAO-04-751T: Published: May 5, 2004. Publicly Released: May 5, 2004.
The Sustainable Growth Rate (SGR) system, implemented in 1998 and subsequently revised, is used to update Medicare's physician fees and moderate the growth in Medicare spending for physician services. SGR, and a predecessor system implemented in 1992, were designed to reduce physician fee updates if spending growth exceeded a specified target. Although spending growth slowed substantially under bo...
Medicare: Discrepancy in Hospital Outpatient Prospective Payment System Methodology Leads to Inaccurate Beneficiary Copayments and Medicate Payments
GAO-04-103R: Published: Oct 6, 2003. Publicly Released: Oct 6, 2003.
Under the Medicare hospital outpatient prospective payment system (OPPS), beneficiaries can be responsible for paying 50 percent or more of the total payment for outpatient services they receive in hospitals. The Balanced Budget Act of 1997 (BBA) introduced a mechanism to gradually decrease beneficiary cost sharing to 20 percent of the payment rate for each hospital outpatient service. The Centers...
Ambulance Services: Medicare Payments Can Be Better Targeted to Trips in Less Densely Populated Rural Areas
GAO-03-986: Published: Sep 19, 2003. Publicly Released: Sep 19, 2003.
The Centers for Medicare & Medicaid Services (CMS) recently implemented a Medicare ambulance fee schedule in which providers are paid a base payment per trip plus a mileage payment. An adjustment is made to the mileage rate for rural trips to account for higher costs. CMS has stated that this rural adjustment may not sufficiently target providers serving sparsely populated rural areas. The Medicar...
Skilled Nursing Facilities: Available Data Show Average Nursing Staff Time Changed Little after Medicare Payment Increase
GAO-03-176: Published: Nov 13, 2002. Publicly Released: Nov 13, 2002.
The nation's 15,000 skilled nursing facilities (SNF) play an essential role in our health care system, providing Medicare-covered skilled nursing and rehabilitative care each year for 1.4 million Medicare patients who have recently been discharged from acute care hospitals. In recent years, many analysts and other observers, including members of Congress, have expressed concern about the level of...
Medicare Hospital and Physician Payments: Geographic Cost Adjustments Important to Preserve Beneficiary Access to Services
GAO-02-968T: Published: Jul 23, 2002. Publicly Released: Jul 23, 2002.
This testimony discusses Medicare program payment adjustments to hospitals and physicians that account for geographic differences in costs. Because Medicare's hospital and physician payment systems are based on national rates, these geographic cost adjustments are essential to account for costs beyond providers' control and to ensure that beneficiaries have adequate access to services. If these ad...
Medicare Physician Payments: Spending Targets Encourage Fiscal Discipline, Modifications Could Stabilize Fees
GAO-02-441T: Published: Feb 14, 2002. Publicly Released: Feb 14, 2002.
Congress implemented a physician fee schedule and a fee update formula to moderate spending growth relative to specified Medicare spending targets. These spending targets increase annually to reflect higher costs for physician services, the growth in the overall economy, and changes in the number of Medicare beneficiaries. Physician fees are adjusted for changes in the costs of providing services...
Medicare Management: CMS Faces Challenges to Sustain Progress and Address Weaknesses
GAO-01-817: Published: Jul 31, 2001. Publicly Released: Aug 31, 2001.
Considering the complexity, the size, and the statutory constraints affecting the Medicare Program, some contend that the Health Care Financing Administration's (HCFA)--recently renamed the Centers for Medicare and Medicaid Services--management of Medicare has, on balance, been satisfactory. Others argue that HCFA's management has been unacceptable. HCFA's record has been mixed and the agency's ch...
Skilled Nursing Facilities: Services Excluded From Medicare's Daily Rate Need to be Reevaluated
GAO-01-816: Published: Aug 22, 2001. Publicly Released: Aug 22, 2001.
Congress and the Health Care Financing Administration recognized that certain services needed to be excluded from the skilled nursing facility (SNF) prospective payment system (PPS) rate to help ensure beneficiary access to appropriate care and to financially protect the SNFs that take care of high-cost patients. The criteria used to identify services--high cost, infrequently provided during a SNF...
Medicare: More Beneficiaries Use Hospice but for Fewer Days of Care
HEHS-00-182: Published: Sep 18, 2000. Publicly Released: Sep 18, 2000.
Pursuant to a congressional request, GAO provided information on the Medicare hospice benefit, focusing on: (1) the patterns and trends in hospice use by Medicare beneficiaries; (2) factors that affect the use of the hospice benefit; and (3) the availability of hospice providers to serve the needs of Medicare beneficiaries.GAO noted that: (1) the number of Medicare beneficiaries choosing hospice s...
Medicare Hospital Payment: PPS Includes Several Policies Intended to Help Rural Hospitals
HEHS-00-174R: Published: Sep 15, 2000. Publicly Released: Sep 15, 2000.
Pursuant to a congressional request, GAO provided information on the scope and efficacy of Medicare's existing rural hospital inpatient payment policies, focusing on the major special payment provisions available to rural hospitals under the prospective payment system (PPS) and to provide information on the inpatient financial performance of these hospitals under PPS.GAO noted that: (1) Medicare h...