Hospital care services (21 - 30 of 60 items)
Medicare: Discrepancy in Hospital Outpatient Prospective Payment System Methodology Leads to Inaccurate Beneficiary Copayments and Medicate Payments
GAO-04-103R: Published: Oct 6, 2003. Publicly Released: Oct 6, 2003.
Under the Medicare hospital outpatient prospective payment system (OPPS), beneficiaries can be responsible for paying 50 percent or more of the total payment for outpatient services they receive in hospitals. The Balanced Budget Act of 1997 (BBA) introduced a mechanism to gradually decrease beneficiary cost sharing to 20 percent of the payment rate for each hospital outpatient service. The Centers...
Medicare: Modest Eligibility Expansion for Critical Access Hospital Program Should Be Considered
GAO-03-948: Published: Sep 19, 2003. Publicly Released: Sep 19, 2003.
Critical Access Hospitals (CAHs) are small rural hospitals that receive payment for their reasonable costs of providing inpatient and outpatient services to Medicare beneficiaries, rather than being paid fixed amounts under Medicare's prospective payment systems. Between fiscal years 1997 and 2002, 681 hospitals have become CAHs. In the Medicare, Medicaid and SCHIP Benefits Improvement and Protect...
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...
HCFA: Medicare Program's Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for 1997
OGC-97-5: Published: Nov 8, 1996. Publicly Released: Nov 8, 1996.
Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on the Medicare Program's inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1997. GAO found that: (1) the new rule would, based on a formula contained in the Medicare statute, set the 1997 inpatient hospital deductible at $760, the daily coinsur...
VA Health Care: Albuquerque Medical Center Not Recovering Full Costs of Lithotripsy Services
HEHS-95-19: Published: Dec 28, 1994. Publicly Released: Feb 1, 1995.
Pursuant to a congressional request, GAO reviewed the Department of Veterans Affairs' (VA) Albuquerque Medical Center's contracting practices, focusing on: (1) whether the center fully recovered the government's cost of providing nonveteran lithotripsy services; and (2) the effects of the center's pricing policy on competition for lithotripsy services in the Albuquerque area.GAO found that: (1) in...
German Health Reforms: Changes Result in Lower Health Costs in 1993
HEHS-95-27: Published: Dec 16, 1994. Publicly Released: Dec 16, 1994.
GAO reviewed the German health care system, focusing on the: (1) effects of nonnegotiable budgets on health care cost and access to care; and (2) status of some of the structural changes intended to control costs over the longer term.GAO found that: (1) during 1993, the German health care sectors generally succeeded in controlling the growth of health care costs, with outlays per member falling mo...
Health Care Reform: Potential Difficulties in Determining Eligibility for Low-Income People
HEHS-94-176: Published: Jul 11, 1994. Publicly Released: Aug 1, 1994.
Pursuant to a congressional request, GAO provided information on the problems applicants face in enrolling in the Medicaid program, focusing on the: (1) reasons why eligible applicants are not being enrolled; (2) incentives hospitals have to facilitate patient enrollment; and (3) potential impact of health care reform on Medicaid eligibility determinations.GAO found that: (1) many people who are p...
Medicare and Medicaid: Many Eligible People Not Enrolled in Qualified Medicare Beneficiary Program
HEHS-94-52: Published: Jan 20, 1994. Publicly Released: Jan 25, 1994.
Pursuant to a congressional request, GAO reviewed: (1) government efforts to publicize the Qualified Medicare Beneficiary (QMB) program; and (2) suggestions for increasing enrollment in QMB.GAO found that: (1) 2 million people eligible for the QMB program did not enroll in the program in 1991; (2) federal and state efforts to publicize the QMB program have not had a significant effect on the QMB e...
1993 German Health Reforms: Initiatives Tighten Cost Controls
T-HRD-94-2: Published: Oct 13, 1993. Publicly Released: Oct 13, 1993.
GAO discussed the German health care system, focusing on the approaches used to control health care costs. GAO noted that: (1) before 1993, Germany had budget caps on physician and hospital services that were negotiated by provider associations and sickness funds that provide health insurance to most Germans; (2) German health care reforms limit physician and hospital expenditures to increases in...
1993 German Health Reforms: New Cost Control Initiatives
HRD-93-103: Published: Jul 7, 1993. Publicly Released: Aug 10, 1993.
Pursuant to a congressional request, GAO examined recent German health care reforms, focusing on: (1) the reasons for the German reforms; (2) the nature of the reforms; (3) the initial reaction to and expected effects of the reforms; and (4) implications for U.S. health care reforms.GAO found that: (1) large increases in mandated health care premiums and variations in contribution rates between he...