Health insurance cost control (21 - 30 of 170 items)
Private Health Insurance: Number and Market Share of Carriers in the Small Group Health Insurance Market
GAO-02-536R: Published: Mar 25, 2002. Publicly Released: Apr 29, 2002.
GAO reviewed the small group health insurance market to identify the number of licensed carriers, the largest carriers, and their market share in each state. GAO found that (1) the median number of licensed carriers in the small group market per state was 28, (2) the median market share of the largest carrier was about 33 percent, (3) the five largest carriers, when combined, represented three-qua...
Medigap: Current Polices Contain Coverage Gaps, Undermine Cost Control Incentives
GAO-02-533T: Published: Mar 14, 2002. Publicly Released: Mar 14, 2002.
Medicare provides valuable and extensive health care coverage for 40 million elderly and disabled beneficiaries. Nevertheless, significant gaps leave some beneficiaries vulnerable to sizeable out-of-pocket expenses. Medicare provides no limit on out-of-pocket spending and no coverage for most outpatient prescription drugs. Most beneficiaries have supplemental coverage that helps to fill Medicare c...
Medicare Physician Payments: Spending Targets Encourage Fiscal Discipline, Modifications Could Stabilize Fees
GAO-02-441T: Published: Feb 14, 2002. Publicly Released: Feb 14, 2002.
Congress implemented a physician fee schedule and a fee update formula to moderate spending growth relative to specified Medicare spending targets. These spending targets increase annually to reflect higher costs for physician services, the growth in the overall economy, and changes in the number of Medicare beneficiaries. Physician fees are adjusted for changes in the costs of providing services...
Children's Health Insurance: SCHIP Enrollment and Expenditure Information
GAO-01-993R: Published: Jul 25, 2001. Publicly Released: Sep 6, 2001.
Congress created the State Children's Health Insurance Program (SCHIP) in 1997 to reduce the number of uninsured poor children whose families incomes are too high to qualify for Medicaid. Congress appropriated $40 billion over 10 years (fiscal years 1998 through 2007) for SCHIP. Each state's SCHIP allotment is available as a federal match based on state expenditures. Although the SCHIP statute gen...
Medicare Management: CMS Faces Challenges to Sustain Progress and Address Weaknesses
GAO-01-817: Published: Jul 31, 2001. Publicly Released: Aug 31, 2001.
Considering the complexity, the size, and the statutory constraints affecting the Medicare Program, some contend that the Health Care Financing Administration's (HCFA)--recently renamed the Centers for Medicare and Medicaid Services--management of Medicare has, on balance, been satisfactory. Others argue that HCFA's management has been unacceptable. HCFA's record has been mixed and the agency's ch...
Medigap Insurance: Plans Are Widely Available but Have Limited Benefits and May Have High Costs
GAO-01-941: Published: Jul 31, 2001. Publicly Released: Jul 31, 2001.
To protect themselves against large out-of-pocket expenses and help fill gaps in Medicare coverage, most beneficiaries buy supplemental insurance, known as Medigap; contribute to employer-sponsored health benefits to supplement Medicare coverage; or enroll in private Medicare+Choice plans rather than traditional fee-for-service Medicare. Because Medicare+Choice plans are not available everywhere...
Medicare: Successful Reform Requires Meeting Key Management Challenges
GAO-01-1006T: Published: Jul 25, 2001. Publicly Released: Jul 25, 2001.
Management of Medicare has come under increasing scrutiny. The Health Care Financing Administration (HCFA) has had mixed success running the program. The agency has developed payment methods that have contained cost growth, and HCFA has paid fee-for-service claims quickly and at low administrative cost. However, HCFA has had difficulty ensuring that it paid claims appropriately. In addition, Medic...
Medicare Management: Current and Future Challenges
GAO-01-878T: Published: Jun 19, 2001. Publicly Released: Jun 19, 2001.
Medicare is a popular program that millions of Americans depend on for covering their essential health needs. However, the management of the program has fallen short of expectations because it has not always appropriately balanced or satisfied the needs of beneficiaries, providers, and taxpayers. For example, stakeholders expect that Medicare will price services prudently; that providers will be t...
Retiree Health Benefits: Employer-Sponsored Benefits May Be Vulnerable to Further Erosion
GAO-01-374: Published: May 1, 2001. Publicly Released: May 31, 2001.
In 1999, nearly 10 million retired people aged 55 or older relied on employer-sponsored health insurance as either their primary source of coverage or as a supplement to their Medicare coverage. Some of these persons are concerned about the continued availability of employer-sponsored coverage. Premium increases and forecasts for a potential economic slowdown could further erode employer-sponsored...
Medicare: Cost Sharing Policies Problematic for Beneficiaries and Program
GAO-01-713T: Published: May 9, 2001. Publicly Released: May 9, 2001.
Medicare provides valuable and extensive health care coverage for beneficiaries. Nevertheless, significant gaps leave some beneficiaries vulnerable to sizeable financial burdens from out-of-pocket expenses. Medigap is a widely available source of supplemental coverage. This testimony discusses (1) beneficiaries' potential financial liability under Medicare's current benefit structure and cost-shar...