Health care cost control (31 - 40 of 199 items)
Medicare Advantage: Increased Spending Relative to Medicare Fee-for-Service May Not Always Reduce Beneficiary Out-of-Pocket Costs
GAO-08-359: Published: Feb 22, 2008. Publicly Released: Feb 28, 2008.
In 2006, the federal government spent about $59 billion on Medicare Advantage (MA) plans, an alternative to the original Medicare fee-for-service (FFS) program. Although health plans were originally envisioned in the 1980s as a potential source of Medicare savings, such plans have generally increased program spending. Payments to MA plans have been estimated to be 12 percent greater than what Medi...
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...
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...
Medicaid Long-Term Care: Few Transferred Assets before Applying for Nursing Home Coverage; Impact of Deficit Reduction Act on Eligibility Is Uncertain
GAO-07-280: Published: Mar 26, 2007. Publicly Released: Apr 25, 2007.
The Medicaid program paid for nearly one-half of the nation's total long-term care expenditures in 2004. To be eligible for Medicaid long-term care, individuals may transfer assets (income and resources) to others to ensure that their assets fall below certain limits. Individuals who make transfers for less than fair market value (FMV) can be subject to a penalty that may delay Medicaid coverage....
Health Care Spending: Public Payers Face Burden of Entitlement Program Growth, While All Payers Face Rising Prices and Increasing Use of Services
GAO-07-497T: Published: Feb 15, 2007. Publicly Released: Feb 15, 2007.
GAO testified about the challenges involved in financing health care. GAO has been particularly concerned about the federal government's long-term fiscal sustainability and the contribution of health care spending to this troubling picture. For the past several years, we have consistently reported that in just a few decades, the government will face a serious fiscal imbalance driven by known demog...
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...
Medicare: CMS's Beneficiary Education and Outreach Efforts for the Medicare Prescription Drug Discount Card and Transitional Assistance Program
GAO-06-139R: Published: Nov 18, 2005. Publicly Released: Nov 30, 2005.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 required the Centers for Medicare & Medicaid Services (CMS) in the Department of Health and Human Services (HHS) to broadly disseminate information on the program to the millions of Medicare beneficiaries--seniors and people under age 65 with permanent disabilities--who are eligible for a drug discount card. In response, CM...
DOD and VA Health Care: Incentives Program for Sharing Health Resources
GAO-05-310R: Published: Feb 28, 2005. Publicly Released: Feb 28, 2005.
Combined, the Department of Defense (DOD) and the Department of Veterans Affairs (VA) provide health care services to about 16.8 million beneficiaries at an estimated cost of $58 billion for fiscal year 2005--$30.4 billion for DOD and $27.7 billion for VA. In 1982, the Congress passed the Veterans' Administration and Department of Defense Health Resources Sharing and Emergency Operations Act (Shar...
Medicare: CMS's Program Safeguards Did Not Deter Growth in Spending for Power Wheelchairs
GAO-05-43: Published: Nov 17, 2004. Publicly Released: Dec 15, 2004.
Medicare spending for power wheelchairs--one of the program's most expensive items of durable medical equipment (DME)--rose more than fourfold from 1999 through 2003, while overall Medicare spending rose by about 11 percent for the same period, according to the Centers for Medicare & Medicaid Services (CMS). This spending growth has raised concerns that some of the payments may have been improper...
Medicare Physician Payments: Concerns about Spending Target System Prompt Interest in Considering Reforms
GAO-05-85: Published: Oct 8, 2004. Publicly Released: Oct 8, 2004.
Concerns were raised about the current system Medicare uses to determine annual changes to physician fees--the sustainable growth rate (SGR) system--when fees were reduced by 5.4 percent in 2002. Subsequent administrative and legislative actions modified or overrode the SGR system, resulting in fee increases for 2003, 2004, and 2005. However, projected fee reductions for 2006-2012 have raised new...