Physicians (11 - 20 of 77 items)
Medicare Physician Payment: Care Coordination Programs Used in Demonstration Show Promise, but Wider Use of Payment Approach May Be Limited
GAO-08-65: Published: Feb 15, 2008. Publicly Released: Feb 15, 2008.
Congress mandated in 2000 that the Centers for Medicare & Medicaid Services (CMS) conduct the Physician Group Practice (PGP) Demonstration to test a hybrid payment methodology for physician groups that combines Medicare fee-for-service payments with new incentive payments. The 10 participants, with 200 or more physicians each, may earn annual bonus incentive payments by achieving cost savings and...
Primary Care Professionals: Recent Supply Trends, Projections, and Valuation of Services
GAO-08-472T: Published: Feb 12, 2008. Publicly Released: Feb 12, 2008.
Most of the funding for programs under title VII of the Public Health Service Act goes toward primary care medicine and dentistry training and increasing medical student diversity. Despite a longstanding objective of title VII to increase the total supply of primary care professionals, health care marketplace signals suggest an undervaluing of primary care medicine, creating a concern about the fu...
End-of-Life Care: Key Components Provided by Programs in Four States
GAO-08-66: Published: Dec 14, 2007. Publicly Released: Jan 14, 2008.
Approximately 28 percent of all Medicare spending in 1999 was used to provide care for beneficiaries in the last year of their lives. The Medicare hospice benefit is specifically designed for end-of-life care but is an elected benefit for individuals who have a terminal diagnosis with a prognosis of 6 months or less if the disease runs its normal course. GAO was asked to identify examples of progr...
Highlights of a Forum: Health Care 20 Years From Now--Taking Steps Today to Meet Tomorrow's Challenges
GAO-07-1155SP: Published: Sep 7, 2007. Publicly Released: Sep 7, 2007.
"Unless we fix our health care system--in both the public and private sectors--rising health care costs will have severe, adverse consequences for the federal budget as well as the U.S. economy in the future." This is one of the key messages that Comptroller General David M. Walker has been delivering across the country in town-hall style meetings, in speeches, and on radio and television programs...
Medicare Physician Services: Use of Services Increasing Nationwide and Relatively Few Beneficiaries Report Major Access Problems
GAO-06-704: Published: Jul 21, 2006. Publicly Released: Jul 21, 2006.
Congress, policy analysts, and groups representing physicians have periodically raised concerns that Medicare's efforts to control spending on physician services by limiting annual updates to physician fees could have an adverse impact on beneficiaries' access to physician services. These concerns were heightened in 2002 when Medicare's formula for setting physician fees required a 5.4 percent red...
Federal Employees Health Benefits Program: First-Year Experience with High-Deductible Health Plans and Health Savings Accounts
GAO-06-271: Published: Jan 31, 2006. Publicly Released: Feb 2, 2006.
The Federal Employees Health Benefits Program (FEHBP) recently began offering high-deductible health plans (HDHP) coupled with tax-advantaged health savings accounts (HSA) that enrollees use to pay for health care. Unused HSA balances may accumulate for future use, providing enrollees an incentive to purchase health care prudently. The plans also provide decision support tools to help enrollees ma...
Specialty Hospitals: Information on Potential New Facilities
GAO-05-647R: Published: May 19, 2005. Publicly Released: Jun 9, 2005.
Beginning in the 1990s, there was a substantial increase in the number of short-term acute care hospitals that primarily treat patients with specific medical conditions or who need surgical procedures. Advocates of such hospitals, commonly referred to as specialty hospitals, contend that their focused missions and dedicated resources can both improve quality and reduce health care costs. Critics c...
Medicare Physician Fee Schedule: CMS Needs a Plan for Updating Practice Expense Component
GAO-05-60: Published: Dec 13, 2004. Publicly Released: Dec 13, 2004.
Medicare's payments for the costs physicians incur in operating their practices are based on two sets of estimates: total practice expenses and resource estimates for individual services. Total practice expense estimates were derived from American Medical Association (AMA) physician surveys, which the Centers for Medicare & Medicaid Services (CMS) refines with supplemental data submitted by medica...
Medicare Chemotherapy Payments: New Drug and Administration Fees Are Closer to Providers' Costs
GAO-05-142R: Published: Dec 1, 2004. Publicly Released: Dec 1, 2004.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) required the Secretary of the Department of Health and Human Services to change the payment rates for chemotherapy-related drugs and chemotherapy administration services. These changes followed reports that Medicare payments for chemotherapy-related drugs were much higher than physicians' costs to acquire them, and on...
Medicare: Recent CMS Reforms Address Carrier Scrutiny of Physicians' Claims for Payment
GAO-02-693: Published: May 28, 2002. Publicly Released: May 28, 2002.
In 1990, GAO designated the Medicare program to be at high-risk for waste, fraud, and abuse. More than a decade later, Medicare remains on GAO's high-risk list. This report examines Medicare's claims review process, which is designed to detect improper billing or payments. GAO found that most physicians who bill Medicare are largely unaffected by carriers' medical reviews, with 90 percent of physi...