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Medicare Managed Care: HMO Rates, Other Factors Create Uneven Availability of Benefits

T-HEHS-97-133 Published: May 19, 1997. Publicly Released: May 19, 1997.
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Highlights

GAO discussed aspects of Medicare managed care, including greater choice and equity across the program, focusing on: (1) the link between counties' capitation rates and Medicare's spending on fee-for-service care; (2) factors affecting the availability of plans in a given area, the level of premiums charged, and the benefit packages offered; and (3) modifications to Medicare's current payment methodology that could reduce health maintenance organization (HMO) overpayments.

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CompetitionHealth care programsHealth insurance cost controlHealth maintenance organizationsHealth resources utilizationInsurance premiumsManaged health careMedical economic analysisMedical services ratesMedicareOverpaymentsCapitation (medical care)