Health care services (31 - 40 of 139 items)
Medicaid Third-Party Liability: Federal Guidance Needed to Help States Address Continuing Problems
GAO-06-862: Published: Sep 15, 2006. Publicly Released: Oct 17, 2006.
Medicaid, jointly funded by the federal government and the states, finances health care for about 56 million low-income people at an estimated total cost of about $298 billion in fiscal year 2004. Congress intended Medicaid to be the payer of last resort: if Medicaid beneficiaries have another source of health care coverage--such as private health insurance or a health plan purchased individually...
Consumer-Directed Health Plans: Small but Growing Enrollment Fueled by Rising Cost of Health Care Coverage
GAO-06-514: Published: Apr 28, 2006. Publicly Released: May 30, 2006.
Insurance carriers, employers, and individuals are showing increasing interest in consumer-directed health plans (CDHP). CDHPs typically combine a high-deductible health plan with a health reimbursement arrangement (HRA) or health savings account (HSA). HRAs and HSAs are tax-advantaged accounts used to pay enrollees' health care expenses, and unused balances may accrue for future use, potentially...
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...
Defense Health Care: Health Insurance Stipend Program Expected to Cost More Than TRICARE But Could Improve Continuity of Care for Dependents of Activated Reserve Component Members
GAO-06-128R: Published: Oct 19, 2005. Publicly Released: Oct 19, 2005.
Since the September 11, 2001, terrorist attacks, the Department of Defense (DOD) has increased its reliance on its National Guard and reserve forces to support the Global War on Terrorism, and particularly Operation Iraqi Freedom. Congress has been interested in making improvements and enhancements to compensation and benefit programs for reserve component members. When reserve component members a...
Managing Diabetes: Health Plan Coverage of Services and Supplies
GAO-05-210: Published: Feb 25, 2005. Publicly Released: Mar 28, 2005.
Diabetes, which afflicts millions of Americans, is a manageable disease whose effects can be mitigated with proper care, regularly received. Experts recommend certain services and supplies for managing diabetes. Because these can be costly, concerns exist about whether individuals with diabetes have access to and receive what they need. Little is known, however, about health plan coverage of diabe...
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...
Medicaid Managed Care: Access and Quality Requirements Specific to Low-Income and Other Special Needs Enrollees
GAO-05-44R: Published: Dec 8, 2004. Publicly Released: Dec 8, 2004.
The use of managed care within Medicaid, a joint federal-state program that finances health insurance for certain low-income families with children and individuals who are aged or disabled, increased significantly during the 1990s. By 2003, 59 percent of Medicaid beneficiaries were enrolled in managed care, compared with less than 10 percent in 1991. Medicaid managed care, under which states make...
Medicare Demonstration PPOs: Financial and Other Advantages for Plans, Few Advantages for Beneficiaries
GAO-04-960: Published: Sep 27, 2004. Publicly Released: Sep 27, 2004.
Preferred provider organizations (PPO) are more prevalent than other types of health plans in the private market, but, in 2003, only six PPOs contracted to serve Medicare beneficiaries in Medicare+Choice (M+C), Medicare's private health plan option. In recent years, the Centers for Medicare & Medicaid Services (CMS), the agency that administers Medicare, initiated two demonstrations that include a...
Milwaukee Health Care Spending Compared to Other Metropolitan Areas: Geographic Variation in Spending for Enrollees in the Federal Employees Health Benefits Program
GAO-04-1000R: Published: Aug 18, 2004. Publicly Released: Aug 23, 2004.
Health care spending varies across the country due to differences in the use and price of health care services. Understanding the reasons for utilization and price variation may contribute to developing methods to control health care spending. This report provides preliminary results from our work on geographic variations in health care spending and prices. Congress asked us to examine geographic...
Private Health Insurance: Coverage of Key Colorectal Cancer Screening Tests is Common but Not Universal
GAO-04-713: Published: Jun 17, 2004. Publicly Released: Jul 19, 2004.
Colorectal cancer is the second leading cause of cancer deaths in the United States. Its mortality can be reduced through early detection and treatment. Four key tests are used to detect the cancer--fecal occult blood test (FOBT), flexible sigmoidoscopy, double-contrast barium enema (DCBE), and colonoscopy. Private health insurance plans generally cover these tests to diagnose cancer; however, the...