Health care services (41 - 50 of 1,004 items)
Behavioral Health: Options for Low-Income Adults to Receive Treatment in Selected States
GAO-15-449: Published: Jun 19, 2015. Publicly Released: Jul 20, 2015.
Nationwide, estimates using 2008-2013 data indicated that approximately 17 percent of low-income, uninsured adults (3 million) had a behavioral health condition, defined as a serious mental illness, a substance use condition, or both. Underlying these national estimates is considerable variation at the state level.Estimated Percentage of Low-Income, Uninsured Adults with Behavioral Health Conditio...
Medicaid: Service Utilization Patterns for Beneficiaries in Managed Care
GAO-15-481: Published: May 29, 2015. Publicly Released: Jun 29, 2015.
Based on GAO's analysis of 2010 encounter data reported by 19 states, the number of professional services utilized by adult beneficiaries ranged from about 13 to 55. For children, the number of professional services utilized per beneficiary was lower, ranging from about 6 to 16 among the 19 states. Professional services included four categories of services: (1) evaluation and management (E/M) serv...
VA Health Care: Improvements Needed to the Monitoring of Antidepressant Use for Major Depressive Disorder and the Accuracy of Suicide Data
GAO-15-648T: Published: Jun 10, 2015. Publicly Released: Jun 10, 2015.
Department of Veterans Affairs (VA) policy states that antidepressant treatment must be consistent with VA's current clinical practice guideline (CPG) for major depressive disorder (MDD); however, GAO's recent review of 30 veterans' medical records found that most contained deviations. For example, although the CPG recommends that veterans' depressive symptoms be assessed at 4-6 weeks after initia...
Medicare Administrative Contractors: CMS Should Consider Whether Alternative Approaches Could Enhance Contractor Performance
GAO-15-372: Published: Apr 30, 2015. Publicly Released: Jun 1, 2015.
As of February 2015, 16 Medicare Administrative Contractors (MAC) administered claims submitted by Medicare providers and suppliers. Twelve were A/B MACs that administered Medicare Part A and Part B claims for inpatient hospital care, outpatient physician and hospital services, and home health and hospice care, among other services, in specific jurisdictions. Four other MACs administered claims fo...
VA Health Care: Actions Needed to Improve Monitoring and Oversight of Non-VA and Contract Care
GAO-15-654T: Published: Jun 1, 2015. Publicly Released: Jun 1, 2015.
GAO's recent work has found significant weaknesses in the Department of Veterans Affairs' (VA) monitoring and oversight of its Non-VA Medical Care Program. Through this program, care is provided to veterans by non-VA providers in non-VA facilities. As GAO reported in May 2013, VA did not collect data on wait times veterans face in obtaining care from non-VA providers. Having data on wait times for...
Medicare: Results from the First Two Years of the Pioneer Accountable Care Organization Model
GAO-15-401: Published: Apr 22, 2015. Publicly Released: May 22, 2015.
Health care providers and suppliers voluntarily form accountable care organizations (ACO) to provide coordinated care to patients with the goal of reducing spending while improving quality. Within the Centers for Medicare & Medicaid Services (CMS), the Center for Medicare & Medicaid Innovation (CMMI) began testing the Pioneer ACO Model in 2012. Under this model, ACOs can earn additional Medicare p...
Veterans Affairs Health Care: Addition to GAO's High Risk List and Actions Needed for Removal
GAO-15-580T: Published: Apr 29, 2015. Publicly Released: Apr 29, 2015.
To determine which federal government programs and functions should be designated high risk, GAO considers a number of factors. For example, it assesses whether the risk involves public health or safety, service delivery, national security, national defense, economic growth, or privacy or citizens' rights, or whether the risk could result in significantly impaired service, program failure, injury...
Persons with HIV: Funding Formula for Housing Assistance Could Be Better Targeted, and Performance Data Could Be Improved
GAO-15-298: Published: Apr 16, 2015. Publicly Released: Apr 16, 2015.
The extent to which persons with human immunodeficiency virus (HIV) need housing assistance is not known, in part because the Department of Housing and Urban Development's (HUD) estimate of the housing needs of persons with HIV, including those with Acquired Immune Deficiency Syndrome (AIDS), is not reliable. HUD does not require Housing Opportunities for Persons with AIDS (HOPWA) grantees to use...
Sole Community Hospitals: Early Indications Show That TRICARE's Revised Reimbursement Rules Have Not Affected Access to Care
GAO-15-402: Published: Apr 15, 2015. Publicly Released: Apr 15, 2015.
TRICARE's revised reimbursement rules for Sole Community Hospitals (SCHs), which provide health care in rural areas or where similar hospitals do not exist under certain criteria, approximate those for Medicare's. Specifically, both programs reimburse SCHs using the greater of either a cost-based amount or the allowed amount under a diagnostic-related-group-based payment system, although each prog...
Health Care Funding: Federal Obligations to and Expenditures by Selected Entities Involved in Health-Related Activities, 2010-2012
GAO-15-270R: Published: Mar 20, 2015. Publicly Released: Mar 25, 2015.
From fiscal year 2010 through 2012, the Department of Health and Human Services (HHS) and the U.S. Agency for International Development (USAID) reported obligating about $236 million to six organizations and their affiliates and member associations: Advocates for Youth, Guttmacher Institute, International Planned Parenthood Federation, Planned Parenthood Federation of America, Population Council,...