Managed health care (61 - 70 of 107 items)
Defense Health Care: Medicare Costs and Other Issues May Affect Uniformed Services Treatment Facilities' Future
HEHS-96-124: Published: May 17, 1996. Publicly Released: May 17, 1996.
Pursuant to a congressional request, GAO reviewed the integration of uniformed services treatment facilities (USTF) into the Department of Defense's (DOD) TRICARE Program, focusing on: (1) whether USTF members' use of Medicare and the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) results in unnecessary costs; and (2) other issues that need to be considered during USTF pro...
Medicare: Private Payer Strategies Suggest Options to Reduce Rapid Spending Growth
T-HEHS-96-138: Published: Apr 30, 1996. Publicly Released: Apr 30, 1996.
GAO discussed strategies to curb Medicare spending, which has grown by over 10 percent a year since 1989, twice the rate of the national economy. GAO noted that: (1) Medicare has not used tools used by private health care payers to manage and improve its utilization, reimbursement, and claims policies and procedures; (2) Medicare's smaller categories of services, which are typically less managed a...
Health Care Delivery Quality Issue Area: Active Assignments
AA-96-12(2): Published: Apr 6, 1996. Publicly Released: Apr 6, 1996.
GAO provided information on its active assignments in its Health Care Delivery and Quality issue area as of April 6, 1996...
Health Financing and Public Health Issue Area: Active Assignments
AA-96-14(2): Published: Apr 6, 1996. Publicly Released: Apr 6, 1996.
GAO provided information on its active assignments in its Health Financing and Public Health issue area as of April 6, 1996...
Prescription Drugs and the Elderly: Many Still Receive Potentially Harmful Drugs Despite Recent Improvements
T-HEHS-96-114: Published: Mar 28, 1996. Publicly Released: Mar 28, 1996.
GAO reviewed the inappropriate use of prescription drugs among the elderly. GAO noted that: (1) according to 1992 data, about 17.5 percent of the almost 30 million Medicare beneficiaries were prescribed drugs inappropriate for their age; (2) factors that contribute to the inappropriate use of drugs include poor coordination among patients, doctors, and pharmacists, and the absence of guidelines fo...
Defense Health Care: TRICARE Progressing, but Some Cost and Performance Issues Remain
T-HEHS-96-100: Published: Mar 7, 1996. Publicly Released: Mar 7, 1996.
GAO discussed the Department of Defense's (DOD) implementation of TRICARE, its nationwide managed health care program. GAO noted that: (1) although early TRICARE implementation is basically proceeding as planned, there was some initial beneficiary confusion due to a shortage of adequately trained staff and uncoordinated education and marketing efforts; (2) DOD needs to gather demographic and other...
Health Insurance for Children: State and Private Programs Create New Strategies to Insure Children
HEHS-96-35: Published: Jan 18, 1996. Publicly Released: Feb 20, 1996.
Pursuant to a congressional request, GAO reviewed state and private efforts to insure children who are not eligible for Medicaid and whose parents cannot purchase private insurance, focusing on: (1) enrollment, costs, funding sources, and annual budgets of these state and private programs; (2) state strategies to manage costs while providing children access to health care; and (3) program design e...
Pharmacy Benefit Managers: Early Results on Ventures With Drug Manufacturers
T-HEHS-96-85: Published: Feb 7, 1996. Publicly Released: Feb 7, 1996.
GAO discussed the role of pharmacy benefit managers (PBM) in the health care market, focusing on the effects of mergers between pharmaceutical manufacturers and PBM. GAO found that: (1) PBM help health insurers control their drug costs by encouraging the use of formularies, creating pharmacy networks, negotiating rebates with drug manufacturers, substituting generic drugs, and conducting drug util...
Health Care Delivery and Quality Issue Area: Active Assignments
AA-96-12(1): Published: Jan 2, 1996. Publicly Released: Jan 2, 1996.
GAO provided information on its active assignments in the Health Care Delivery and Quality issue area as of January 2, 1996...
Medicaid Section 1115 Waivers: Flexible Approach to Approving Demonstrations Could Increase Federal Costs
HEHS-96-44: Published: Nov 8, 1995. Publicly Released: Dec 8, 1995.
Pursuant to a congressional request, GAO examined the financing arrangements for four approved section 1115 Medicaid demonstration waivers.GAO found that: (1) the approved spending limits for demonstration waivers in Oregon, Hawaii, and Florida are not budget neutral and could increase federal Medicaid expenditures; (2) Tennessee's 1115 waiver agreement should cost less than the continuation of it...