Health insurance (1 - 10 of 139 items)
Private Health Insurance: In Most States and New Exchanges, Enrollees Continued to be Concentrated among Few Issuers in 2014 [Reissued on February 14, 2017]
GAO-16-724: Published: Sep 6, 2016. Publicly Released: Sep 6, 2016.
GAO found that enrollment in private health insurance plans remained concentrated among a small number of issuers in most states in 2014, including in the newly established exchanges. On average in each state and the District of Columbia, 11 or more issuers participated in each of three types of marketsâ€”individual, small group, and large groupâ€”from 2011 through 2014. However, in most states, t...
Private Health Insurance: The Range of Premiums and Plan Availability for Individuals in 2014 and 2015
GAO-15-687: Published: Aug 10, 2015. Publicly Released: Sep 9, 2015.
As of 2014, key provisions of the Patient Protection and Affordable Care Act (PPACA) resulted in the establishment of health insurance exchanges in each state and changed how insurers determined health insurance premiums. Individual market consumers generally had access to more health plans in 2015 compared to 2014, and in both years the lowest-cost plans were available through exchanges in most o...
Private Health Insurance: Concentration of Enrollees among Individual, Small Group, and Large Group Insurers from 2010 through 2013
GAO-15-101R: Published: Dec 1, 2014. Publicly Released: Dec 1, 2014.
The Patient Protection and Affordable Care Act (PPACA) requires GAO to study competition and market concentration in the health insurance market. For this study, we examined individual, small group, and large group health insurance markets prior to the implementation of key PPACA provisions that went into effect in 2014 and that could affect competition and market concentration among health insure...
Patient Protection and Affordable Care Act: Preliminary Results of Undercover Testing of Enrollment Controls for Health Care Coverage and Consumer Subsidies Provided Under the Act
GAO-14-705T: Published: Jul 23, 2014. Publicly Released: Jul 23, 2014.
Centers for Medicare & Medicaid Services (CMS) officials told us they have internal controls for health care coverage eligibility determinations. GAO's undercover testing addressed processes for identity- and income-verification, with preliminary results revealing questions as follows: For 12 applicant scenarios, GAO tested "front-end" controls for verifying an applicant's identity or citizenship/...
Consumer Finance: Credit Cards Designed for Medical Services Not Covered by Insurance
GAO-14-570: Published: Jun 19, 2014. Publicly Released: Jul 21, 2014.
Multiple entities offer medical credit cards, but according to market participants with whom GAO spoke, CareCredit LLC issues the majority of medical credit cards. In 2013, the company reported 4.4 million cardholders and 177,000 participating providers in its network, the majority of which were dental offices. Several other financial institutions also issue medical credit cards, usually offering...
Medicaid Payment: Comparisons of Selected Services under Fee-for-Service, Managed Care, and Private Insurance
GAO-14-533: Published: Jul 15, 2014. Publicly Released: Jul 15, 2014.
Payments to physicians under Medicaid fee-for-service (FFS) and managed care for the 26 evaluation and management (E/M) services, such as office visits and emergency care, that GAO reviewed were generally lower than private insurance prior to the temporary increases mandated by the Health Care and Education Reconciliation Act of 2010 (HCERA). Specifically, in the 40 states where GAO compared Medic...
Department of Health and Human Services: Solicitations of Support for Enroll America
GAO-14-305R: Published: Mar 21, 2014. Publicly Released: Apr 21, 2014.
GAOâ€™s review of written responses and documentation from the Department of Health and Human Services (HHS) found that, since enactment of the Patient Protection and Affordable Care Act (PPACA), the Secretary of HHS (the Secretary) contacted the Chief Executive Officers of five organizations to solicit support for one outside entity, Enroll America, involved in activities related to PPACA. Specif...
Medicare: Continuous Insurance before Enrollment Associated with Better Health and Lower Program Spending
GAO-14-53: Published: Dec 17, 2013. Publicly Released: Jan 16, 2014.
Beneficiaries with continuous health insurance coverage for approximately 6 years before enrolling in Medicare were more likely than those without prior continuous insurance to report being in good health or better during the first 6 years in Medicare. In particular, having prior continuous insurance raised the predicted probability that a beneficiary reported being in good health or better by nea...
Children's Health Insurance: Information on Coverage of Services, Costs to Consumers, and Access to Care in CHIP and Other Sources of Insurance
GAO-14-40: Published: Nov 21, 2013. Publicly Released: Dec 20, 2013.
In five selected states, GAO determined that the separate State Children's Health Insurance Program (CHIP) plans were generally comparable to the benchmark plans selected by states in 2012 as models for the benefits that will be offered through qualified health plans (QHP) in 2014. The plans were comparable in the services they covered and the services on which they imposed limits, although there...
Indian Health Service: Most American Indians and Alaska Natives Potentially Eligible for Expanded Health Coverage, but Action Needed to Increase Enrollment
GAO-13-553: Published: Sep 5, 2013. Publicly Released: Sep 5, 2013.
GAO estimates, on the basis of recent U.S. Census Bureau data, that most American Indians and Alaska Natives will be potentially eligible for either expanded or new coverage options created by the Patient Protection and Affordable Care Act (PPACA). These options include expanded eligibility for Medicaid--the federal-state program for certain low-income individuals--and eligibility for the Health I...