Health care cost control (91 - 100 of 648 items)
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...
Medicare Hospital and Physician Payments: Geographic Cost Adjustments Important to Preserve Beneficiary Access to Services
GAO-02-968T: Published: Jul 23, 2002. Publicly Released: Jul 23, 2002.
This testimony discusses Medicare program payment adjustments to hospitals and physicians that account for geographic differences in costs. Because Medicare's hospital and physician payment systems are based on national rates, these geographic cost adjustments are essential to account for costs beyond providers' control and to ensure that beneficiaries have adequate access to services. If these ad...
VA and DOD Health Care: Factors Contributing to Reduced Pharmacy Costs and Continuing Challenges
GAO-02-969T: Published: Jul 22, 2002. Publicly Released: Jul 22, 2002.
The Department of Veterans Affairs (VA) and the Department of Defense (DOD) pharmacy expenditures have risen significantly, reflecting national trends. The increase in pharmacy costs would have been even greater if not for the efforts taken by VA and DOD. GAO identified four important factors that have contributed to reduced pharmacy spending by VA and DOD. First, the two departments have used for...
VA and Defense Health Care: Potential Exists for Savings through Joint Purchasing of Medical and Surgical Supplies
GAO-02-872T: Published: Jun 26, 2002. Publicly Released: Jun 26, 2002.
The Department of Veterans Affairs (VA) spent $500 million and the Department of Defense (DOD) spent $240 million for medical and surgical supplies in fiscal year 2001. Since the 1980s, To achieve greater efficiencies through improved acquisition processes and increased sharing of medical resources, VA and DOD signed a memorandum of agreement in 1999 to combine their buying power. VA and DOD saved...
Medicare: Challenges Remain in Setting Payments for Medical Equipment and Supplies and Covered Drugs
GAO-02-833T: Published: Jun 12, 2002. Publicly Released: Jun 12, 2002.
Medicare has paid higher than market rates for various medical equipment and supplies and often considerably higher than provider acquisition costs for Medicare-covered outpatient drugs. Congress has enacted a series of legislative changes affecting payment methods and payment adjustment authority for medical equipment and supplies and outpatient drugs since the late 1980s. However, progress in se...
Retired Coal Miners' Health Benefit Funds: Financial Challenges Continue
GAO-02-243: Published: Apr 18, 2002. Publicly Released: May 20, 2002.
More than 100,000 retired coal miners and their spouses and dependents in 1992 faced a potential decrease in their employment-related health insurance coverage or loss of such coverage altogether. Some former employers had stopped mining coal or gone out of business and were no longer contributing to the United Mine Workers of America (UMWA) retiree benefit funds. To ensure that these individuals...
VA Health Care: Changes Needed to Improve Resource Allocation to Health Care Networks
GAO-02-744T: Published: May 14, 2002. Publicly Released: May 14, 2002.
The Department of Veterans Affairs (VA) spent $21 billion in fiscal year 2001 to treat 3.8 million veterans--most of whom had service-connected disabilities or low incomes. Since 1997, VA has used the Veterans Equitable Resource Allocation (VERA) system to allocate most of its medical care appropriation. GAO found that VERA has had a substantial impact on network resource allocations and workloads...
Group Purchasing Organizations: Pilot Study Suggests Large Buying Groups Do Not Always Offer Hospitals Lower Prices
GAO-02-690T: Published: Apr 30, 2002. Publicly Released: Apr 30, 2002.
This testimony discusses group purchasing organizations (GPO) for medical devices and supplies used in hospitals. By pooling the purchases of their member hospitals, these specialized firms negotiate lower prices from vendors. GAO found that a hospital's use of a GPO contract did not guarantee that the hospital saved money: GPOs' prices were not always lower and were often higher than prices paid...
Medicare: Financial Outlook Poses Challenges for Sustaining Program and Adding Drug Coverage
GAO-02-643T: Published: Apr 17, 2002. Publicly Released: Apr 17, 2002.
The lack of outpatient prescription drug coverage may leave Medicare's most vulnerable beneficiaries with high out-of-pocket costs. Recent estimates suggest that, at any given time, more than a third of Medicare beneficiaries lack prescription drug coverage. The rest have some coverage through various sources--most commonly employer-sponsored health plans. Recent evidence indicates that this cover...
Medicare Outpatient Drugs: Program Payments Should Better Reflect Market Prices
GAO-02-531T: Published: Mar 14, 2002. Publicly Released: Mar 14, 2002.
In some cases, Medicare pays significantly more for covered outpatient drugs than the actual costs to the physicians and pharmacy suppliers. Attempts to reduce these payments have been met with provider claims that overpayments for the drugs are needed to cover underpayments for administering or delivering them. Medicare's method for establishing drug payments is flawed. Medicare pays 95 percent o...