Managed health care (11 - 20 of 107 items)
DOD Pharmacy Benefits Program: Reduced Pharmacy Costs Resulting from the Uniform Formulary and Manufacturer Rebates
GAO-08-172R: Published: Oct 31, 2007. Publicly Released: Oct 31, 2007.
Rising pharmacy costs have been a long-standing issue for the Department of Defense (DOD). In 1998, we reported that DOD's fiscal year 1997 total pharmacy costs were $1.3 billion--a 13 percent increase from fiscal year 1995. In fiscal year 2006, DOD dispensed 115 million prescriptions to about 6.5 million beneficiaries at a cost of about $6 billion. One effort to control pharmacy costs is through...
Medicare: CMS Did Not Control Rising Power Wheelchair Spending
GAO-04-716T: Published: Apr 28, 2004. Publicly Released: Apr 28, 2004.
Medicare spending for power wheelchairs, one of the program's most expensive items of durable medical equipment (DME), rose 450 percent from 1999 through 2003, while overall Medicare spending rose by about 11 percent for the same period, according to the Centers for Medicare & Medicaid Services (CMS). This spending growth has raised concerns that Medicare made improper payments and has payment rat...
Prescription Drug Discount Cards: Savings Depend on Pharmacy and Type of Card Used
GAO-03-912: Published: Sep 3, 2003. Publicly Released: Sep 8, 2003.
While prescription drugs have become an increasingly important part of health care for the elderly, more than one-quarter of all Medicare beneficiaries have no prescription drug coverage. Over the past decade, private companies and not-for-profit organizations have sponsored prescription drug discount cards that offer discounts from the prices the elderly would otherwise have to pay for their pres...
Medicare: Financial Challenges and Considerations for Reform
GAO-03-577T: Published: Apr 10, 2003. Publicly Released: Apr 10, 2003.
We are pleased to be here today as Congress examines Medicare's financial health and consider the budgetary and economic challenges presented by an aging society. The Comptroller General has been particularly attentive to the sustainability challenges faced by the nation's two largest entitlement programs--Medicare and Social Security--for more than a decade since he served as a public trustee for...
Medicare: Observations on Program Sustainability and Strategies to Control Spending on Any Proposed Drug Benefit
GAO-03-650T: Published: Apr 9, 2003. Publicly Released: Apr 9, 2003.
The House Committee on Ways and Means is holding a hearing on modernizing Medicare and integrating prescription drugs into the program. There are growing concerns about gaps in the Medicare program, most notably the lack of outpatient prescription drug coverage, which may leave Medicare's most vulnerable beneficiaries with high out-of-pocket costs. At the same time, Medicare already faces a huge p...
Medicare Hospital Payments: Refinements Needed to Better Account for Geographic Differences in Wages
GAO-02-963: Published: Sep 30, 2002. Publicly Released: Sep 30, 2002.
The Medicare program's prospective payment system (PPS) for inpatient hospital services provides incentives for hospitals to operate efficiently by paying them a predetermined, fixed amount for each inpatient hospital stay regardless of the actual costs incurred in providing the care. Although the fixed amount is based on national average costs, actual per stay payments vary widely across hospital...
Defense Health Care: Most Reservists Have Civilian Health Coverage but More Assistance Is Needed When TRICARE Is Used
GAO-02-829: Published: Sep 6, 2002. Publicly Released: Sep 6, 2002.
To expand the capabilities of the nation's active duty forces, the Department of Defense (DOD) relies on the 1.2 million men and women of the Reserve and National Guard. Currently, reserve components constitute nearly half of the total armed forces. Although DOD requires reservists to use TRICARE DOD's health care system for their own health care, using TRICARE is an option for their dependents. N...
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...
Medigap: Current Polices Contain Coverage Gaps, Undermine Cost Control Incentives
GAO-02-533T: Published: Mar 14, 2002. Publicly Released: Mar 14, 2002.
Medicare provides valuable and extensive health care coverage for 40 million elderly and disabled beneficiaries. Nevertheless, significant gaps leave some beneficiaries vulnerable to sizeable out-of-pocket expenses. Medicare provides no limit on out-of-pocket spending and no coverage for most outpatient prescription drugs. Most beneficiaries have supplemental coverage that helps to fill Medicare c...
Retiree Health Insurance: Gaps in Coverage and Availability
GAO-02-178T: Published: Nov 1, 2001. Publicly Released: Nov 1, 2001.
In 1999, about 10 million Americans aged 55 and older relied on employer-sponsored health benefits until they became eligible for Medicare or to pay for out-of-pocket expenses not covered by Medicare. However, the number of employers offering these benefits has declined considerably during the past decade. Despite the recent strong economy and the relatively low increases in health insurance premi...