Health care cost control (71 - 80 of 97 items)
Medicare: Improvements Needed in the Identification of Inappropriate Hospital Care
PEMD-90-7: Published: Dec 20, 1989. Publicly Released: Dec 20, 1989.
Pursuant to a congressional request, GAO examined both Medicare and private programs' approaches to assessing the appropriateness of hospital care and reducing the level of inappropriate hospital care.GAO found that: (1) both the Medicare and private programs conducted utilization review activities, typically involving nurses' examination of medical records and referral of suspected inappropriate...
Medicare: Impact of State Mandatory Assignment Programs on Beneficiaries
HRD-89-128: Published: Sep 19, 1989. Publicly Released: Oct 20, 1989.
Pursuant to a congressional request, GAO assessed the impact of four states' mandatory assignment laws, which required physicians to accept Medicare's approved amount as full payment for certain health care services, on: (1) Medicare beneficiaries' and non-beneficiaries' out-of-pocket costs; (2) physician services volume and intensity; and (3) Medicare beneficiaries' access to health care.GAO foun...
Medicare: Statutory Modifications Needed for the Peer Review Program Monetary Penalty
HRD-89-18: Published: Mar 30, 1989. Publicly Released: Mar 30, 1989.
GAO reviewed the Department of Health and Human Services' (HHS) Office of the Inspector General's (OIG) actions on monetary penalties recommended by peer review organizations (PRO) against hospitals and physicians for improper or unnecessary health care services to Medicare beneficiaries.GAO found that OIG: (1) revised its policy partially to meet a statutory provision limiting monetary fines to t...
Medicare: Physician-Sponsored Organizations Receive Priority for Peer Review Contracts
HRD-88-43: Published: Jan 21, 1988. Publicly Released: Jan 21, 1988.
In response to a congressional request, GAO determined whether the Health Care Financing Administration (HCFA) complied with a requirement to give physician-sponsored organizations preference in the award of contracts for peer review organizations (PRO).GAO found that: (1) in 1986, HCFA awarded PRO contracts to physician-sponsored organizations in 75 percent of the cases where they were competing...
Medicare: Payments to Radiologists, Anesthesiologists, and Pathologists
HRD-87-114BR: Published: Jul 20, 1987. Publicly Released: Jul 28, 1987.
Pursuant to a congressional request, GAO provided information on: (1) Medicare reimbursements for radiologists, anesthesiologists, and pathologists (RAP); and (2) the market structure for RAP services.GAO found that Medicare generally pays RAP on the same basis as other physicians, but limits reimbursement for: (1) inpatient radiology services because radiologists' capital costs for such services...
Medical Malpractice: A Framework for Action
HRD-87-73: Published: May 20, 1987. Publicly Released: Jun 8, 1987.
In response to a congressional request, GAO assessed the problems relating to increases in the cost of medical malpractice insurance in recent years, focusing on: (1) states' attempts to deal with the problems; and (2) possible state and federal actions.GAO found that, although it could not identify an obvious cause for the increase in malpractice insurance or any specific ways to prevent further...
Medical Malpractice: Six State Case Studies Show Claims and Insurance Costs Still Rise Despite Reforms
HRD-87-21: Published: Dec 31, 1986. Publicly Released: Dec 31, 1986.
In response to a congressional request, GAO provided information on the medical malpractice insurance situation, problems, and reforms in six states to determine if their attempts since the mid-1970's to reduce insurance costs, the number of claims filed, and the average amount paid per claim were successful.GAO found that: (1) most of the changes the states made focused on tort reforms to ensure...
Medical Malpractice: Insurance Costs Increased but Varied Among Physicians and Hospitals
HRD-86-112: Published: Sep 15, 1986. Publicly Released: Sep 22, 1986.
In response to congressional requests, GAO reviewed the medical malpractice situation in the United States, including the costs of malpractice insurance for physicians and hospitals.GAO found that: (1) total malpractice insurance costs for physicians increased from $1.7 billion in 1983 to $3.4 billion in 1985; (2) the costs varied widely by specialty, by state, and within some states; (3) as a per...
Medicare: Reviews of Quality of Care at Participating Hospitals
HRD-86-139: Published: Sep 15, 1986. Publicly Released: Sep 15, 1986.
GAO reported on the quality of medical care provided to in-hospital Medicare beneficiaries, specifically the Health Care Financing Administration's (HCFA) increased requirements for utilization and quality control peer review organizations (PRO) to monitor the quality of care provided.GAO reviewed PRO in California, Florida, and Georgia. Although HCFA expanded its requirements for the second contr...
Medicare: Physician Income by Specialty and Place of Service
HRD-86-90BR: Published: Jul 24, 1986. Publicly Released: Jul 24, 1986.
Pursuant to a congressional request, GAO reviewed: (1) the gross and net incomes of office-based physicians by specialty; (2) the portions of physicians' gross incomes that were earned from the Medicare program and its beneficiaries; (3) the locations where doctors earned their money from Medicare; and (4) the extent to which physicians accepted the Medicare allowable charge as the full charge for...