Managed health care (51 - 60 of 86 items)
Medicare: Progress to Date in Implementing Certain Major Balanced Budget Act Reforms
T-HEHS-99-87: Published: Mar 17, 1999. Publicly Released: Mar 17, 1999.
Pursuant to a congressional request, GAO discussed the implementation and impact of the Medicare provisions in the Balanced Budget Act of 1997 (BBA), focusing on: (1) the Medicare Choice program, particularly the payment method and consumer information efforts; and (2) prospective payment systems (PPS) for skilled nursing facilities (SNF) and home health agencies (HHA) in Medicare's traditional fe...
Medicare Managed Care: Better Risk Adjustment Expected to Reduce Excess Payments Overall While Making Them Fairer to Individual Plans
T-HEHS-99-72: Published: Feb 25, 1999. Publicly Released: Feb 25, 1999.
Pursuant to a congressional request, GAO discussed the adjustment of Medicare's payments to managed care plans in the Medicare Choice program, focusing on the: (1) importance of improving the current risk adjustment method; (2) implications of rate-setting changes implemented in 1998; and (3) the advantages and drawbacks of the Health Care Financing Administration's (HCFA) proposed new interim ris...
Health Insurance for Children: Private Individual Coverage Available, but Choices Can Be Limited and Costs Vary
HEHS-98-201: Published: Aug 5, 1998. Publicly Released: Aug 13, 1998.
Pursuant to a congressional request, GAO reviewed the availability of private sector health coverage for children in the individual insurance market, focusing on: (1) the availability and characteristics of private health insurance products that can be purchased only for a child and how these products differ from other individual private insurance products; (2) the costs of these child-only produc...
Federal Health Programs: Comparison of Medicare, the Federal Employees Health Benefits Program, Medicaid, Veterans' Health Services, Department of Defense Health Services, and Indian Health Services
HEHS-98-231R: Published: Aug 7, 1998. Publicly Released: Aug 7, 1998.
GAO compared the Medicare program with five other federal health programs: the Federal Employees Health Benefits Program (FEHBP); the Medicaid and Department of Veterans' Affairs (VA) health programs; the Department of Defense's (DOD) TRICARE health program; and the Indian Health Service (IHS). GAO also compared key features of these programs, including: (1) administrative structures, including th...
Health Services Quality and Public Health Issue Area Plan: Fiscal Years 1999-2000
IAP-98-14: Published: Aug 1, 1998. Publicly Released: Aug 1, 1998.
GAO provided information on its Health Services Quality and Public Health issue area plan for fiscal years 1999 and 2000.GAO plans to: (1) determine whether the public health service agencies are ensuring the public's health and safety efficiently and effectively; (2) identify opportunities for improving the quality of health care under fee-for-service and managed care payment arrangements; (3) id...
Balanced Budget Act: Implementation of Key Medicare Mandates Must Evolve to Fulfill Congressional Objectives
T-HEHS-98-214: Published: Jul 16, 1998. Publicly Released: Jul 16, 1998.
GAO discussed the Health Care Financing Administration's (HCFA) implementation of Medicare provisions contained in the Balanced Budget Act of 1997 (BBA), focusing on: (1) an overview of how HCFA's implementation has progressed since GAO's earlier testimony; (2) the efforts to inform Medicare beneficiaries about the expanded health plan choices available to them in 1999, commonly referred to as the...
Health Plan Quality Information: Efforts to Report on PPO Plan Performance
HEHS-98-213R: Published: Jul 16, 1998. Publicly Released: Jul 16, 1998.
Pursuant to a congressional request, GAO provided information on preferred provider organization (PPO) plan performance, focusing on: (1) large health care purchasers' efforts to collect and disseminate quality performance information about PPO plans; and (2) existing requirements for PPOs to demonstrate quality assurance efforts.GAO noted that: (1) some of the largest health care purchasers in th...
HCFA: Medicare Program--Establishment of the Medicare+Choice Program
OGC-98-60: Published: Jul 13, 1998. Publicly Released: Jul 13, 1998.
Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on the establishment of the Medicare Plus Choice program. GAO noted that: (1) the rule would implement provisions of the Balanced Budget Act of 1997 which established a new Medicare Plus Choice program that significantly expands the health care options available to Medicare beneficiaries;...
Medicare Managed Care Appeal Process for Denials of Care: A Comparison With Recommendations From the President's Quality Commission
HEHS-98-155R: Published: May 8, 1998. Publicly Released: Jun 8, 1998.
Pursuant to a congressional request, GAO reviewed information on Medicare managed care appeals to help Congress consider legislation on national appeal rights for private-sector health care consumers, focusing on: (1) comparing the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry's recommended appeal process with that required by the Medicare program;...
Health Financing and Systems Issues: Issue Area Plan for Fiscal Years 1999-2001
IAP-98-13: Published: Jun 1, 1998. Publicly Released: Jun 1, 1998.
GAO provided information on its Health Financing and Systems issue area plan for fiscal years 1999-2001.GAO plans to examine: (1) how effectively the Health Care Financing Administration is managing Medicare's fee-for-service and managed care components--particularly the implementation of recent legislative reforms; (2) how payment and pricing reforms will be implemented and what effect they might...