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Medicare HMOs: Setting Payment Rates Through Competitive Bidding

HEHS-97-154R Published: Jun 12, 1997. Publicly Released: Jun 12, 1997.
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Highlights

GAO reviewed the Health Care Financing Administration's (HCFA) proposed use of competitive bidding as an alternative method for setting Medicare health maintenance organization (HMO) payment rates, focusing on: (1) the potential advantages of competitive bidding in the Medicare HMO program; (2) the main features of HCFA's planned competitive bidding demonstration in Denver; and (3) HMO's key objections to it.

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Competitive procurementHealth care programsHealth insurance cost controlHealth maintenance organizationsInsurance premiumsManaged health careMedicaidMedical services ratesMedicareOverpayments