Managed health care (31 - 40 of 86 items)
Medicaid Managed Care: States' Safeguards for Children With Special Needs Vary Significantly
HEHS-00-169: Published: Sep 29, 2000. Publicly Released: Oct 30, 2000.
Pursuant to a congressional request, GAO reviewed the Medicaid managed care services for children with special needs, focusing on the: (1) extent to which states are enrolling children with special needs, as defined by the Balanced Budget Act (BBA), in capitated managed care plans; and (2) scope and effectiveness of the safeguards states are implementing to ensure that children with special needs...
Medicare+Choice: Plan Withdrawals Indicate Difficulty of Providing Choice While Achieving Savings
HEHS-00-183: Published: Sep 7, 2000. Publicly Released: Sep 7, 2000.
Pursuant to a congressional request, GAO reviewed health care plans' withdrawal from the Medicare Choice program, focusing on the: (1) geographic distribution and the distribution among plans of enrollees affected by the recent plan withdrawals; (2) factors associated with plans that terminated or reduced their participation in the program; and (3) likely role of payment rates in affecting plans'...
Medicare and Managed Care Plans: Payments and Costs for Selected Hospitals
HEHS-00-177R: Published: Sep 1, 2000. Publicly Released: Sep 1, 2000.
Pursuant to a congressional request, GAO reviewed Medicare and managed care plan hospital costs and payments, focusing on: (1) the relationship between Medicare and managed care plan payments and costs; (2) managed care plan payments and the relative importance of managed care business; and (3) Medicare and managed care plan payments and costs by hospital teaching status.GAO noted that: (1) for th...
Medicare+Choice: Payments Exceed Cost of Fee-for-Service Benefits, Adding Billions to Spending
HEHS-00-161: Published: Aug 23, 2000. Publicly Released: Aug 23, 2000.
Pursuant to a congressional request, GAO reviewed Medicare Choice program payment issues, focusing on: (1) whether program spending for Medicare Choice plan enrollees has exceeded what Medicare-covered care for these beneficiaries would have cost in the fee-for-service (FFS) Medicare program; and (2) the extent to which payments to individual plans differ from expected FFS costs.GAO noted that: (1...
Children With Disabilities: Medicaid Can Offer Important Benefits and Services
T-HEHS-00-152: Published: Jul 12, 2000. Publicly Released: Jul 12, 2000.
Pursuant to a congressional request, GAO discussed the feasibility of allowing some families with children with disabilities to purchase Medicaid coverage, focusing on: (1) what role Medicaid plays in providing health care coverage for children with disabilities; (2) the extent to which private insurance offers coverage of needed services for children with disabilities; and (3) the benefits and se...
Mental Health Parity Act: Despite New Federal Standards, Mental Health Benefits Remain Limited
HEHS-00-95: Published: May 10, 2000. Publicly Released: May 18, 2000.
Pursuant to a congressional request, GAO reviewed the implementation of the Mental Health Parity Act of 1996, focusing on the: (1) extent to which employers comply with the law and how they have revised their health plans; (2) law's effect on claims costs; and (3) steps federal agencies have taken to ensure compliance with the law.GAO noted that: (1) 86 percent of the responding employers in the 2...
Health Care Access: Programs for Underserved Populations Could Be Improved
T-HEHS-00-81: Published: Mar 23, 2000. Publicly Released: Mar 23, 2000.
Pursuant to a congressional request, GAO discussed the effectiveness of the Health Resources and Services Administration's (HRSA) two safety-net programs--the Community and Migrant Health Center program and the National Health Service Corps--to improve access to medically underserved populations.GAO noted that: (1) both the health centers and the Corps are important safety-net providers to the nat...
Prescription Drug Benefits: Applying Private Sector Management Methods to Medicare
T-HEHS-00-84: Published: Mar 22, 2000. Publicly Released: Mar 22, 2000.
Pursuant to a congressional request, GAO discussed issues related to a potential Medicare outpatient prescription drug benefit, focusing on: (1) the factors contributing to the rise in prescription drug spending and the impact of the rise in spending on Medicare beneficiaries; (2) the methods private insurers have developed to manage these rising costs; and (3) whether and how Medicare can adapt t...
Medicare: HCFA Faces Challenges to Control Improper Payments
T-HEHS-00-74: Published: Mar 9, 2000. Publicly Released: Mar 9, 2000.
Pursuant to a congressional request, GAO discussed the Health Care Financing Administration's (HCFA) efforts to control improper payments in the Medicare program, focusing on the ongoing and emerging challenges HCFA faces in safeguarding Medicare payments.GAO noted that: (1) major information gaps exist in the Medicare program--in both traditional Medicare and Medicare Choice--that impede HCFA's a...
Skilled Nursing Facilities: Medicare Payment Changes Require Provider Adjustments But Maintain Access
HEHS-00-23: Published: Dec 14, 1999. Publicly Released: Dec 14, 1999.
Pursuant to a congressional request, GAO provided information on skilled nursing facilities, focusing on: (1) the initial effect of the skilled nursing facility (SNF) prospective payment system (PPS) on Medicare beneficiaries' access to care; (2) the initial effect of the SNF PPS on providers; and (3) the role the SNF PPS has played in the poor financial performance of large nursing home chains.GA...