Health care services (21 - 30 of 174 items)
Defense Health Care: TRICARE Multiyear Surveys Indicate Problems with Access to Care for Nonenrolled Beneficiaries
GAO-13-364: Published: Apr 2, 2013. Publicly Released: Apr 2, 2013.
In its analysis of the 2008-2011 beneficiary survey data, GAO found that nearly one in three nonenrolled beneficiaries experienced problems finding a civilian provider who would accept TRICARE and that nonenrolled beneficiaries' access to civilian primary care and specialty care providers differed by type of location. Specifically, a higher percentage of nonenrolled beneficiaries in Prime Service...
Preventive Health Activities: Available Information on Federal Spending, Cost Savings, and International Comparisons Has Limitations
GAO-13-49: Published: Dec 6, 2012. Publicly Released: Jan 7, 2013.
The Departments of Health and Human Services (HHS), Veterans Affairs (VA), and Defense (DOD) administer programs that include preventive health activities such as health screenings and education campaigns, but the departments reported that they do not track department-wide spending on these activities. Departments reported that determining such spending is challenging because these activities can...
Medicaid and CHIP: Most Physicians Serve Covered Children but Have Difficulty Referring Them for Specialty Care
GAO-11-624: Published: Jun 30, 2011. Publicly Released: Jun 30, 2011.
Medicaid and the Children's Health Insurance Program (CHIP)--two joint federal-state health care programs for certain low-income individuals--play a critical role in addressing the health care needs of children. The Children's Health Insurance Program Reauthorization Act of 2009 required GAO to study children's access to care under Medicaid and CHIP, including information on physicians' willingnes...
Medicare: Private Sector Initiatives to Bundle Hospital and Physician Payments for an Episode of Care
GAO-11-126R: Published: Jan 31, 2011. Publicly Released: Mar 2, 2011.
In recent years, we and other federal fiscal experts--including the Congressional Budget Office (CBO) and the Medicare Trustees--have noted the rise in Medicare spending and expressed concern that the program is unsustainable in its present form. Concerns about the rising cost of health care are particularly pressing in light of evidence that suggests that greater spending does not necessarily tra...
Health Care Delivery: Features of Integrated Systems Support Patient Care Strategies and Access to Care, but Systems Face Challenges
GAO-11-49: Published: Nov 16, 2010. Publicly Released: Nov 16, 2010.
Health care delivery in the United States often lacks coordination and communication across providers and settings. This fragmentation can lead to poor quality of care, medical errors, and higher costs. Providers have formed integrated delivery systems (IDS) to improve efficiency, quality, and access. The Health Care Safety Net Act of 2008 directed GAO to report on IDSs that serve underserved popu...
VA Health Care: Improved Oversight and Compliance Needed for Physician Credentialing and Privileging Processes
GAO-10-26: Published: Jan 6, 2010. Publicly Released: Jan 6, 2010.
VA has policies to ensure that physicians have appropriate qualifications and clinical abilities through the processes of credentialing, privileging, and continuous monitoring of performance. Results of a VA investigatory report in 2008 cited deficiencies in the Marion, Illinois, VA medical center's (VAMC) credentialing and privileging processes and oversight of its surgical program. This report e...
Medicare: Per Capita Method Can Be Used to Profile Physicians and Provide Feedback on Resource Use
GAO-09-802: Published: Sep 25, 2009. Publicly Released: Oct 26, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 directed the Secretary of Health and Human Services to develop a program to give physicians confidential feedback on the Medicare resources used to provide care to Medicare beneficiaries. GAO was asked to evaluate the per capita methodology for profiling physicians--a method which measures a patient's resource use over a fixed period...
Medicare Physician Services: Utilization Trends Indicate Sustained Beneficiary Access with High and Growing Levels of Service in Some Areas of the Nation
GAO-09-559: Published: Aug 28, 2009. Publicly Released: Sep 28, 2009.
Congress, policy analysts, and groups representing physicians have raised questions about beneficiary access to Medicare physician services. At the same time, high levels of spending for health care in some parts of the country, and rapid increases in spending for physician services, have been identified as factors that threaten the long-term fiscal sustainability of the Medicare program. GAO was...
Private Health Insurance: Research on Competition in the Insurance Industry
GAO-09-864R: Published: Jul 31, 2009. Publicly Released: Aug 31, 2009.
Health care providers and members of Congress have raised concerns that consolidation in the private health insurance industry may be resulting in less competitive markets and contributing to rising health insurance rates paid by consumers and employers. However, measuring the extent of changes in market competition over time or the effects of changes is challenging. In particular, reliable, longi...
Medicare: Improvements Needed to Address Improper Payments in Home Health
GAO-09-185: Published: Feb 27, 2009. Publicly Released: Mar 13, 2009.
Medicare spending on home health totaled $12.9 billion in 2006, up 44 percent from 2002. Concerns have been raised that improper payments from practices indicating fraud and abuse may have contributed to Medicare home health spending and utilization. The Centers for Medicare & Medicaid Services (CMS), the agency that administers Medicare, is responsible for minimizing improper payments made on beh...