Medical fees (11 - 20 of 62 items)
Medicare: Trends in Fees, Utilization, and Expenditures for Imaging Services before and after Implementation of the Deficit Reduction Act of 2005
GAO-08-1102R: Published: Sep 26, 2008. Publicly Released: Sep 26, 2008.
Rapid spending growth for Medicare Part B--which covers physician and other outpatient services--has heightened concerns about the long-range fiscal sustainability of Medicare. Medicare Part B expenditures are expected to increase over the next decade at an average annual rate of about 8 percent, which is faster than the projected 4.8 percent annual growth rate in the national economy over this ti...
Medicare Part B Imaging Services: Rapid Spending Growth and Shift to Physician Offices Indicate Need for CMS to Consider Additional Management Practices
GAO-08-452: Published: Jun 13, 2008. Publicly Released: Jul 14, 2008.
The Centers for Medicare & Medicaid Services (CMS)--an agency within the Department of Health and Human Services (HHS)--and the Congress, through the Deficit Reduction Act of 2005 (DRA), recently acted to constrain spending on imaging services, one of the fastest growing set of services under Medicare Part B, which covers physician and other outpatient services. GAO was asked to provide informatio...
Medicare Physician Payments: Medicare and Private Payment Differences for Anesthesia Services
GAO-07-463: Published: Jul 27, 2007. Publicly Released: Aug 27, 2007.
In 2005 Medicare paid over $1.4 billion for anesthesia services. These services are generally provided by anesthesia practitioners, such as anesthesiologists and certified registered nurse anesthetists (CRNAs). A government-sponsored study found that Medicare payments for anesthesia services are lower than private payments. Congress is concerned that this difference may create regional discrepanci...
TRICARE: Changes to Access Policies and Payment Rates for Services Provided by Civilian Obstetricians
GAO-07-941R: Published: Jul 31, 2007. Publicly Released: Jul 31, 2007.
About 111,000 women covered by the Department of Defense's (DOD) TRICARE program gave birth during 2006. During their pregnancies, about half of these women received obstetric care from physicians and other providers practicing at military hospitals and clinics called military treatment facilities (MTF), while half received their care from civilian physicians and other civilian providers. In recen...
Medicare: Geographic Areas Used to Adjust Physician Payments for Variation in Practice Costs Should Be Revised
GAO-07-466: Published: Jun 29, 2007. Publicly Released: Jul 30, 2007.
The Centers for Medicare & Medicaid Services (CMS) adjusts Medicare physician fees for geographic differences in the costs of operating a medical practice. CMS uses 89 physician payment localities among which fees are adjusted. Concerns have been raised that the boundaries of some payment localities do not accurately address variations in physicians' costs. GAO was asked to examine how CMS has rev...
Medicare: Providing Systematic Feedback to Physicians on their Practice Patterns Is a Promising Step Toward Encouraging Program Efficiency
GAO-07-862T: Published: May 10, 2007. Publicly Released: May 10, 2007.
GAO was asked to discuss--based on Medicare: Focus on Physician Practice Patterns Can Lead to Greater Program Efficiency, GAO-07-307 (Apr. 30, 2007)--the importance in Medicare of providing feedback to physicians on how their use of health care resources compares with that of their peers. GAO's report discusses an approach to analyzing physicians' practice patterns in Medicare and ways the Centers...
Medicare: Focus on Physician Practice Patterns Can Lead to Greater Program Efficiency
GAO-07-307: Published: Apr 30, 2007. Publicly Released: Apr 30, 2007.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) directed GAO to study the compensation of physicians in traditional fee-for service (FFS) Medicare. GAO explored linking physician compensation to efficiency--defined as providing and ordering a level of services that is sufficient to meet a patient's health care needs but not excessive, given the patient's health sta...
Medicare Spending: Preliminary Findings Regarding an Approach Focusing on Physician Practice Patterns to Foster Program Efficiency
GAO-07-567T: Published: Mar 6, 2007. Publicly Released: Mar 6, 2007.
Medicare's current system of spending targets used to moderate spending growth for physician services and annually update physician fees is problematic. This spending target system--called the sustainable growth rate (SGR) system--adjusts physician fees based on the extent to which actual spending aligns with specified targets. In recent years, because spending has exceeded the targets, the system...
Medicare Physician Payments: Trends in Service Utilization, Spending, and Fees Prompt Consideration of Alternative Payment Approaches
GAO-06-1008T: Published: Jul 25, 2006. Publicly Released: Jul 25, 2006.
In 2002, the system Medicare uses to determine annual changes to physician fees--the sustainable growth rate (SGR) system--reduced fees by almost 5 percent. Subsequent administrative and legislative actions averted fee declines in 2003 through 2006. Absent additional actions, fee reductions are projected for 2007 through 2015. Consequently, the appropriateness of the SGR system has been questioned...
Medicare Physician Services: Use of Services Increasing Nationwide and Relatively Few Beneficiaries Report Major Access Problems
GAO-06-704: Published: Jul 21, 2006. Publicly Released: Jul 21, 2006.
Congress, policy analysts, and groups representing physicians have periodically raised concerns that Medicare's efforts to control spending on physician services by limiting annual updates to physician fees could have an adverse impact on beneficiaries' access to physician services. These concerns were heightened in 2002 when Medicare's formula for setting physician fees required a 5.4 percent red...