Medical services rates (81 - 90 of 111 items)
The High Cost of Health
145025: Jan 1, 1991
This article, which appeared in the GAO Journal, No. 13, Summer/Fall 1991, discusses the high costs of health care and health insurance in the United States, focusing on: (1) the factors to which rising health care costs can be attributed; (2) various health care cost-containment methods that have failed; and (3) reforms that could significantly curb the overall growth of health-care spending...
Medicare: Comparison of Two Methods of Computing Home Health Care Cost Limits
HRD-90-167: Published: Sep 28, 1990. Publicly Released: Sep 28, 1990.
Pursuant to a legislative requirement, GAO provided information on the potential effect on Medicare costs and beneficiaries of limiting home health care costs by type of visit.GAO found that: (1) Medicare home health costs would have been about $36.9 million lower from July 1, 1987, through June 30, 1988, if the cost limits had been applied by type of visit rather than in the aggregate; (2) from J...
Medicare: Second Status Report on Medicare Insured Group Demonstration Projects
HRD-90-117: Published: Jun 6, 1990. Publicly Released: Jun 6, 1990.
Pursuant to a legislative requirement, GAO reviewed the status of the Medicare Insured Groups (MIG) project.GAO found that: (1) a major utility and a life insurance company were analyzing the feasibility of using MIG to provide benefits to retirees; (2) the utility was continuing to develop its proposed method for determining Medicare payment rates, and the insurance company was still in the proce...
Medicare: Durable Medical Equipment Fee Schedules Have Widely Varying Rates
T-HRD-90-32: Published: May 22, 1990. Publicly Released: May 22, 1990.
GAO discussed the appropriateness of Medicare fee schedules for durable medical equipment (DME). GAO noted that: (1) Medicare carriers' fee schedules varied greatly from state to state; (2) for 95 percent of the products, the highest fee schedule amount was at least twice as much as the lowest, and for over 40 percent of the products, the highest amount was at least six times as much as the lowest...
Medicare: GAO Views on Medicare Payments to Health Maintenance Organizations
T-HRD-90-27: Published: May 8, 1990. Publicly Released: May 8, 1990.
GAO discussed Medicare payments to health maintenance organizations (HMO) and the administration's proposal to increase the medicare HMO payment rate. GAO found that: (1) HMO agree to provide all covered health care services to enrolled Medicare beneficiaries in return for a fixed payment; (2) the payment was set at 95 percent of Medicare's estimate of the average cost of fee-for-service health ca...
Screening Mammography: Low-Cost Services Do Not Compromise Quality
HRD-90-32: Published: Jan 10, 1990. Publicly Released: Jan 10, 1990.
Pursuant to a legislative requirement, GAO reviewed the quality of screening mammography provided in different settings.GAO found that: (1) hospitals and private radiology offices performed the majority of screening and diagnostic mammograms; (2) medical professionals established screening mammography standards, but providers did not consistently follow them, and image quality and patient radiatio...
In-Home Services for the Elderly: Cost Sharing Expands Range of Services Provided and Population Served
HRD-90-19: Published: Oct 23, 1989. Publicly Released: Nov 17, 1989.
Pursuant to a congressional request, GAO examined existing state approaches to cost-sharing for in-home services for the elderly, focusing on the: (1) extent to which cost-sharing was currently used; (2) types of services that states cost-shared; (3) benefits and disadvantages of cost-sharing; (4) types of fee schedules used; and (5) characteristics of clients participating in cost-sharing program...
Medicare: Program Provisions and Payments Discourage Hospice Participation
HRD-89-111: Published: Sep 29, 1989. Publicly Released: Sep 29, 1989.
Pursuant to a congressional request, GAO reviewed hospices that were not Medicare-certified, to determine: (1) the factors that influenced a hospice not to participate in Medicare; (2) whether the Health Care Financing Administration (HCFA) set reasonable prospective payment rates for hospices; (3) whether Congress could adopt additional standards to ensure that participating hospices provided qua...
Health Care Financing: Unreimbursed Charges of Selected Children's Hospitals
HRD-89-76: Published: Jul 11, 1989. Publicly Released: Jul 11, 1989.
Pursuant to a congressional request, GAO examined how 13 nonprofit children's hospitals dealt with unreimbursed charges for patient care.GAO found that: (1) unreimbursed charges averaged about 20 percent of the 13 hospitals' total patient care charges in fiscal year (FY) 1986; (2) contractually arranged allowances and discounts accounted for 59 percent of the unreimbursed charges, followed by char...
Medicare: Indirect Medical Education Payments Are Too High
T-HRD-89-14: Published: Apr 11, 1989. Publicly Released: Apr 11, 1989.
GAO discussed Medicare's indirect medical education payments to teaching hospitals. GAO found that: (1) the Prospective Payment System (PPS) set payment rates for hospital operating costs based on diagnosis-related groups and hospital standard payments; (2) hospitals could receive higher PPS payments by treating a disproportionate share of low-income Medicare beneficiaries and additional payments...