Cost analysis (71 - 80 of 100 items)
Medicare Home Health Care: Payments to Home Health Agencies Are Considerably Higher than Costs
GAO-02-663: Published: May 6, 2002. Publicly Released: May 6, 2002.
The Balanced Budget Act of 1997 significantly changed Medicare's home health care payments to home health agencies (HHAs). Under a prospective payment system (PPS), HHAs are paid a fixed amount, adjusted for beneficiary care needs, for providing up to 60 days of care---termed a "home health episode." The act also imposed new interim payment limits to moderate spending until the PPS could be imple...
Medicare: Higher Expected Spending and Call for New Benefit Underscore Need for Meaningful Reform
GAO-01-539T: Published: Mar 22, 2001. Publicly Released: Mar 22, 2001.
Much is at stake when it comes to Medicare reform--not only the program's future but also the nation's fiscal flexibility to pursue other important national goals and programs in the future. A comprehensive effort to reform Medicare and put it on a sustainable path would help fulfill this generation's stewardship responsibility to succeeding generations. It would also help to preserve some capacit...
Medicare and Managed Care Plans: Payments and Costs for Selected Hospitals
HEHS-00-177R: Published: Sep 1, 2000. Publicly Released: Sep 1, 2000.
Pursuant to a congressional request, GAO reviewed Medicare and managed care plan hospital costs and payments, focusing on: (1) the relationship between Medicare and managed care plan payments and costs; (2) managed care plan payments and the relative importance of managed care business; and (3) Medicare and managed care plan payments and costs by hospital teaching status.GAO noted that: (1) for th...
Medicare+Choice: Payments Exceed Cost of Fee-for-Service Benefits, Adding Billions to Spending
HEHS-00-161: Published: Aug 23, 2000. Publicly Released: Aug 23, 2000.
Pursuant to a congressional request, GAO reviewed Medicare Choice program payment issues, focusing on: (1) whether program spending for Medicare Choice plan enrollees has exceeded what Medicare-covered care for these beneficiaries would have cost in the fee-for-service (FFS) Medicare program; and (2) the extent to which payments to individual plans differ from expected FFS costs.GAO noted that: (1...
Medicare Home Health: Effect on Spending of Limiting Payment for Non-Patient-Care Costs
HEHS-00-19R: Published: Oct 19, 1999. Publicly Released: Oct 19, 1999.
Pursuant to a congressional request, GAO modelled the impact of constraining, through various limits, home health agency (HHA) costs that are not directly related to patient care, focusing on the: (1) variation in total and non-patient-care costs across agencies; and (2) effect on Medicare payments if constraints were imposed on payments for non-patient-care costs.GAO noted that: (1) per-visit cos...
Cost Factors in CARE Act Formulas
HEHS-95-256R: Published: Sep 15, 1995. Publicly Released: Sep 15, 1995.
Pursuant to a congressional request, GAO reviewed the effects of proposed acquired immune deficiency syndrome Title I and II funding on eligible metropolitan areas (EMA) and states. GAO noted that: (1) the proposed funding formula, with no cost factor, would increase Title I funding for 30 EMA, decrease funding for 10 EMA, and remain the same for 9 EMA; (2) after 5 years, Title I funding would inc...
Medicaid: Changes in Best Price for Outpatient Drugs Purchased by HMOs and Hospitals
HEHS-94-194FS: Published: Aug 5, 1994. Publicly Released: Aug 5, 1994.
Pursuant to a congressional request, GAO reviewed the best prices for the drugs purchased by health maintenance organizations (HMO) and group purchasing organizations (GPO), focusing on the difference between the drugs' best prices and their best price discount.GAO found that: (1) in the 2 years since the Omnibus Budget Reconciliation Act (OBRA) was enacted, the average best price for outpatient d...
Early Retiree Health: Health Security Act Would Shift Billions in Costs to Federal Government
HEHS-94-203FS: Published: Jul 21, 1994. Publicly Released: Jul 21, 1994.
Pursuant to a congressional request, GAO provided information on the impact of the proposed Health Security Act on retiree health care costs, focusing on the: (1) projected costs of early retiree health benefits for the federal government and U.S. companies; and (2) potential savings for these benefits under the act.GAO noted that: (1) companies and early retirees could realize substantial savings...
Medical Malpractice Insurance Options
HEHS-94-105R: Published: Feb 28, 1994. Publicly Released: Feb 28, 1994.
Pursuant to a congressional request, GAO estimated the costs and savings that federally funded community and migrant health centers could realize by obtaining medical malpractice insurance through either a risk-purchasing group or a risk-retention group compared to their prior insurance coverage. GAO noted that: (1) community health centers could save an estimated $57 million in medical malpractic...
Defense Health Care: Expansion of the CHAMPUS Reform Initiative Into DOD's Region 6
HEHS-94-100: Published: Feb 9, 1994. Publicly Released: Feb 9, 1994.
Pursuant to a legislative requirement, GAO evaluated the Department of Defense's (DOD) certification on expanding the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) Reform Initiative (CRI) to beneficiaries in Arkansas, Oklahoma, and portions of Louisiana and Texas.GAO found that: (1) DOD reasonably evaluated the costs of expanding the modified CRI program to DOD region 6 f...