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Medicare HMOs: HCFA Could Promptly Reduce Excess Payments by Improving Accuracy of County Payment Rates

T-HEHS-97-78 Published: Feb 25, 1997. Publicly Released: Feb 25, 1997.
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Highlights

GAO discussed the rates Medicare pays health maintenance organizations (HMO) in its risk contract program, focusing on: (1) the Health Care Financing Administration's (HCFA) method for setting HMO rates; and (2) GAO's proposed modification of HCFA's HMO rate-setting method.

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Health care costsHealth care programsHealth insurance cost controlHealth maintenance organizationsHealth statisticsMedical economic analysisMedical information systemsMedical services ratesMedicareOverpaymentsStatistical methods