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Other, Department of Health and Human Services, Executive (1 - 10 of 16 items)
Older Americans: Continuing Care Retirement Communities Can Provide Benefits, but Not Without Some Risk
GAO-10-611: Published: Jun 21, 2010. Publicly Released: Jul 21, 2010.
A growing number of older Americans are choosing continuing care retirement communities (CCRC) to help ensure that their finances in retirement will cover the cost of housing and care they may require. However, recent economic conditions have placed financial stress on some CCRCs. GAO was asked to (1) describe how CCRCs operate and the risks they face, (2) describe how state laws address these ris...
Guardianships: Little Progress in Ensuring Protection for Incapacitated Elderly People
GAO-06-1086T: Published: Sep 7, 2006. Publicly Released: Sep 7, 2006.
The Senate Special Committee on Aging asked GAO to follow up on its 2004 report, Guardianships: Collaboration Needed to Protect Incapacitated Elderly People, GAO-04-655. This report covered what state courts do to ensure that guardians fulfill their responsibilities, what exemplary guardianship programs look like, and how state courts and federal agencies work together to protect incapacitated eld...
Assisted Living: Examples of State Efforts to Improve Consumer Protections
GAO-04-684: Published: Apr 30, 2004. Publicly Released: May 27, 2004.
Assisted living facilities provide help with activities of daily living in a residential setting for individuals who cannot live independently but do not require 24-hour skilled nursing care. In 2002, over 36,000 assisted living facilities served approximately 900,000 residents. The states establish and enforce licensing standards for these institutions. Because states have taken widely differing...
Skilled Nursing Facilities: Providers Have Responded to Medicare Payment System By Changing Practices
GAO-02-841: Published: Aug 23, 2002. Publicly Released: Aug 23, 2002.
In 1998, the Health Care Financing Administration implemented a prospective payment system (PPS) for skilled nursing facility (SNF) services provided to Medicare beneficiaries. PPS is intended to control the growth in Medicare spending for skilled nursing and rehabilitative services that SNFs provide. Two years after the implementation of PPS, the mix of patients across the categories of payment g...
Nursing Homes: Sustained Efforts Are Essential to Realize Potential of the Quality Initiatives
HEHS-00-197: Published: Sep 28, 2000. Publicly Released: Sep 28, 2000.
Pursuant to a congressional request, GAO provided information on federal and state initiatives to improve the quality of nursing homes, focusing on: (1) progress in improving the detection of quality problems and changes in measured nursing home quality; (2) the status of efforts to strengthen states' complaint investigation processes and federal enforcement policies; and (3) additional steps take...
Medicare+Choice: Payments Exceed Cost of Fee-for-Service Benefits, Adding Billions to Spending
HEHS-00-161: Published: Aug 23, 2000. Publicly Released: Aug 23, 2000.
Pursuant to a congressional request, GAO reviewed Medicare Choice program payment issues, focusing on: (1) whether program spending for Medicare Choice plan enrollees has exceeded what Medicare-covered care for these beneficiaries would have cost in the fee-for-service (FFS) Medicare program; and (2) the extent to which payments to individual plans differ from expected FFS costs.GAO noted that: (1...
Medicare: Need to Overhaul Costly Payment System for Medical Equipment and Supplies
HEHS-98-102: Published: May 12, 1998. Publicly Released: May 15, 1998.
Pursuant to a congressional request, GAO reviewed Medicare's payments for commonly purchased, off-the-shelf durable medical equipment (DME), focusing on the need to: (1) better identify products billed to Medicare; and (2) bring Medicare fees more in line with current marketplace prices.GAO noted that: (1) there are two underlying problems with Medicare's DME payment system; (2) the Health Care Fi...
Medicaid: States' Efforts to Educate and Enroll Beneficiaries in Managed Care
HEHS-96-184: Published: Sep 17, 1996. Publicly Released: Oct 29, 1996.
Pursuant to a congressional request, GAO provided information on state efforts to enroll Medicaid beneficiaries in managed care, focusing on: (1) the role of managed care organizations (MCO) in marketing and expanding managed care participation; (2) the types of marketing and enrollment abuses that have occurred and states' efforts to curb these abuses and ensure that beneficiaries are informed ab...
Medicaid: Waiver Program for Developmentally Disabled Is Promising But Poses Some Risks
HEHS-96-120: Published: Jul 22, 1996. Publicly Released: Jul 22, 1996.
Pursuant to a congressional request, GAO reviewed states' experiences in utilizing the Medicaid waiver program to provide care for developmentally disabled adults in alternative settings, focusing on: (1) expanding state use of the waiver program; (2) controlling long-term care costs for developmentally disabled individuals; and (3) the strengths and limitations in states' quality assurance approa...
Medical Review Saving
HEHS-94-93R: Published: Feb 28, 1994. Publicly Released: Feb 28, 1994.
Pursuant to a congressional request, GAO evaluated a Medicare contractor's 1992 conversion to a shared part-B Medicare claims processing system, focusing on why the contractor's medical review savings decreased significantly between fiscal years 1991 and 1992. GAO noted that: (1) the contractor's reported medical review savings dropped from $51.2 million for 1991 to $24.3 million in 1992; and (2)...