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Medicare: Health Maintenance Organization Rate-Setting Issues

HRD-89-46 Published: Jan 31, 1989. Publicly Released: Jan 31, 1989.
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Highlights

Pursuant to a legislative requirement, GAO provided an overview of the data and methodology for computing Medicare monthly capitation payments to risk-contract health maintenance organizations (HMO).

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Contractor paymentsHealth care cost controlHealth insuranceHealth insurance cost controlHealth maintenance organizationsMedical services ratesMedicareStatistical methodsCapitation (medical care)Fee-for-service