Managed health care (51 - 60 of 107 items)
Managed Care Initiatives
HEHS-96-153R: Published: Sep 25, 1996. Publicly Released: Oct 28, 1996.
Pursuant to a congressional request, GAO provided information on: (1) tools that managed care plans use to control costs; and (2) state initiatives that address concerns associated with managed care. GAO noted that managed care plans use a variety of tools to control costs, including: (1) shifting some financial risk to providers; (2) requiring plan permission to refer a patient to a specialist; a...
Health, Education, Employment, Social Security, Welfare, and Veterans Reports
HEHS-97-29W: Published: Oct 1, 1996. Publicly Released: Oct 1, 1996.
GAO presented a listing and selected summaries of reports and testimonies issued in September 1996 and a listing of reports issued in June 1996 through September 1996 relating to such issues as: (1) health care reform; (2) Medicare and Medicaid; (3) higher education; (4) training and employment; (5) social security, disability, and welfare benefits; and (5) veterans' and military health care...
Veterans' Affairs and Military Health Care Issue Area Plan--Fiscal Years 1997-98
IAP-96-23: Published: Oct 1, 1996. Publicly Released: Oct 1, 1996.
GAO provided information on its Veterans' Affairs and Military Health Care issue area plan for fiscal years 1997 through 1998.GAO plans to identify: (1) more effective management controls to minimize fraud, waste, and abuse in Department of Veterans Affairs' (VA) and Department of Defense (DOD) health care systems; (2) ways to improve services to veterans and military dependents; (3) options for r...
Medicare: Private-Sector and Federal Efforts to Assess Health Care Quality
T-HEHS-96-215: Published: Sep 19, 1996. Publicly Released: Sep 19, 1996.
GAO discussed the Health Care Financing Administration's (HCFA) efforts to provide health care quality information to Medicare beneficiaries joining health maintenance organizations (HMO). GAO noted that: (1) corporate purchasers use accreditation and performance measurement monitoring to ensure that HMO furnish quality health care; (2) HCFA is starting to use similar methods to ensure HMO quality...
Prescription Drug Pricing: Implications for Retail Pharmacies
T-HEHS-96-216: Published: Sep 19, 1996. Publicly Released: Sep 19, 1996.
GAO discussed the implications of prescription drug pricing for retail pharmacies, focusing on the: (1) changes in the process of getting prescription drugs from manufacturers to patients; and (2) consequences for and response of retail pharmacies to these changes. GAO noted that: (1) health insurers have used their consolidated buying power to obtain drug discounts not available to retail pharmac...
Medigap Insurance: Alternatives for Medicare Beneficiaries to Avoid Medical Underwriting
HEHS-96-180: Published: Sep 10, 1996. Publicly Released: Sep 10, 1996.
Pursuant to a legislative requirement, GAO reviewed Medigap policies, focusing on: (1) the extent to which Medicare beneficiaries are subject to medical underwriting when they change Medigap policies; and (2) options for modifying federal Medigap requirements to ensure that medical underwriting is not a problem in such cases.GAO found that: (1) 11 of the 25 largest Medigap insurers use medical und...
Health Financing and Systems Issue Area: Active Assignments
AA-96-15(4): Published: Sep 3, 1996. Publicly Released: Sep 3, 1996.
GAO provided information on its active assignments in the Health Financing and Systems issue area as of September 3, 1996...
Health Services, Quality and Public Health Issue Area: Active Assignments
AA-96-14(4): Published: Sep 3, 1996. Publicly Released: Sep 3, 1996.
GAO provided information on its active assignments in its Health Services, Quality and Public Health issue area as of September 3, 1996...
Practice Guidelines: Managed Care Plans Customize Guidelines to Meet Local Interests
HEHS-96-95: Published: May 30, 1996. Publicly Released: Jul 1, 1996.
Pursuant to a congressional request, GAO reviewed how managed health plans make use of existing clinical practice guidelines.GAO found that: (1) clinical practice guidelines promote greater uniformity within physician networks, encourage improved efficiency and clinical decision-making, and eliminate unnecessary care; (2) several health plans have adopted clinical practice guidelines to control co...
Defense Health Care: New Managed Care Plan Progressing, but Cost and Performance Issues Remain
HEHS-96-128: Published: Jun 14, 1996. Publicly Released: Jun 14, 1996.
Pursuant to a congressional request, GAO reviewed the Department of Defense's (DOD) implementation of its TRICARE managed health care program, focusing on: (1) whether early implementation produced the expected results; (2) how early outcomes may affect costs; and (3) whether DOD is capturing data needed to manage and assess TRICARE performance.GAO found that: (1) early implementation of TRICARE h...