Managed health care (21 - 30 of 124 items)
VA and DOD Health Care: First Federal Health Care Center Established, but Implementation Concerns Need to Be Addressed
GAO-11-570: Published: Jul 19, 2011. Publicly Released: Jul 19, 2011.
The National Defense Authorization Act (NDAA) for Fiscal Year 2010 authorized the Departments of Veterans Affairs (VA) and Defense (DOD) to establish a 5-year demonstration project to integrate VA and DOD medical care into a first-of-its- kind Federal Health Care Center (FHCC) in North Chicago, Illinois. Expectations for the FHCC are outlined in an Executive Agreement signed by VA and DOD in April...
Medicaid and CHIP: Most Physicians Serve Covered Children but Have Difficulty Referring Them for Specialty Care
GAO-11-624: Published: Jun 30, 2011. Publicly Released: Jun 30, 2011.
Medicaid and the Children's Health Insurance Program (CHIP)--two joint federal-state health care programs for certain low-income individuals--play a critical role in addressing the health care needs of children. The Children's Health Insurance Program Reauthorization Act of 2009 required GAO to study children's access to care under Medicaid and CHIP, including information on physicians' willingnes...
Defense Health Care: Access to Civilian Providers under TRICARE Standard and Extra
GAO-11-500: Published: Jun 2, 2011. Publicly Released: Jun 2, 2011.
The Department of Defense (DOD) provides health care through its TRICARE program, which is managed by the TRICARE Management Activity (TMA). TRICARE offers three basic options. Beneficiaries who choose TRICARE Prime, an option that uses civilian provider networks, must enroll. TRICARE beneficiaries who do not enroll in this option may obtain care from nonnetwork providers under TRICARE Standard or...
Federal Recovery Coordination Program: Enrollment, Staffing, and Care Coordination Pose Significant Challenges
GAO-11-572T: Published: May 13, 2011. Publicly Released: May 13, 2011.
This testimony discusses the challenges facing the Federal Recovery Coordination Program (FRCP)--a program that was jointly developed by the Departments of Defense (DOD) and Veterans Affairs (VA) following critical media reports of deficiencies in the provision of outpatient services at Walter Reed Army Medical Center. This program was established to assist "severely wounded, ill, and injured" Ope...
Medicaid and CHIP: Reports for Monitoring Children's Health Care Services Need Improvement
GAO-11-293R: Published: Apr 5, 2011. Publicly Released: Apr 5, 2011.
Medicaid and the Children's Health Insurance Program (CHIP)--two joint federal-state health care programs for low-income families and children--play a critical role in addressing the health care needs of children. In 2008, more than 36 million children in the United States received health care coverage through Medicaid or CHIP. Like all children, children covered by Medicaid and CHIP may have heal...
DOD and VA Health Care: Federal Recovery Coordination Program Continues to Expand but Faces Significant Challenges
GAO-11-250: Published: Mar 23, 2011. Publicly Released: Mar 23, 2011.
In 2007, following reports of poor case management for outpatients at Walter Reed Army Medical Center, the Departments of Defense (DOD) and Veterans Affairs (VA) jointly developed the Federal Recovery Coordination Program (FRCP) to coordinate the clinical and nonclinical services needed by severely wounded, ill, and injured servicemembers and veterans. The FRCP, which continues to expand, is admin...
Medicare Fraud, Waste, and Abuse: Challenges and Strategies for Preventing Improper Payments
GAO-10-844T: Published: Jun 15, 2010. Publicly Released: Jun 15, 2010.
GAO has designated Medicare as a high-risk program since 1990, in part because the program's size and complexity make it vulnerable to fraud, waste, and abuse. Fraud represents intentional acts of deception with knowledge that the action or representation could result in an inappropriate gain, while abuse represents actions inconsistent with acceptable business or medical practices. Waste, which i...
Defense Health Care: 2008 Access to Care Surveys Indicate Some Problems, but Beneficiary Satisfaction Is Similar to Other Health Plans
GAO-10-402: Published: Mar 31, 2010. Publicly Released: Mar 31, 2010.
The Department of Defense (DOD) provides health care and mental health care through its TRICARE program. Under TRICARE, beneficiaries may obtain care through TRICARE Prime, an option that includes the use of civilian provider networks and requires enrollment. TRICARE beneficiaries who do not enroll in this option may obtain care from nonnetwork providers through TRICARE Standard, or from network p...
Private Health Insurance: Research on Competition in the Insurance Industry
GAO-09-864R: Published: Jul 31, 2009. Publicly Released: Aug 31, 2009.
Health care providers and members of Congress have raised concerns that consolidation in the private health insurance industry may be resulting in less competitive markets and contributing to rising health insurance rates paid by consumers and employers. However, measuring the extent of changes in market competition over time or the effects of changes is challenging. In particular, reliable, longi...
Health Resources and Services Administration: Many Underserved Areas Lack a Health Center Site, and Data Are Needed on Service Provision at Sites
GAO-09-667T: Published: Apr 30, 2009. Publicly Released: Apr 30, 2009.
Health centers funded through grants under the Health Center Program--managed by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS)--provide comprehensive primary care services for the medically underserved. The statement GAO is issuing today summarizes an August 2008 report, Health Resources and Services Administration: Many Underserv...