Health insurance cost control (31 - 40 of 407 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...
Medicare + Choice: Recent Payment Increases Had Little Effect on Benefits or Plan Availability in 2001
GAO-02-202: Published: Nov 21, 2001. Publicly Released: Dec 4, 2001.
The number of contracts under Medicare's managed care program--Medicare+Choice (M+C)--fell from 340 to 180 between 1998 and 2001. The reduction reflected decisions by some managed care organizations (MCOs) to terminate selected contracts or to discontinue service in some covered areas. Although nearly all MCOs renewed at least some of their Medicare contracts over this period, many reduced the geo...
Private Health Insurance: Small Employers Continue to Face Challenges in Providing Coverage
GAO-02-8: Published: Oct 31, 2001. Publicly Released: Dec 3, 2001.
Many small employers--those with 50 or fewer workers--do not offer health benefits to their employees. This is particularly true for employers with fewer than 10 workers. The families of workers employed by small employers are about twice as likely to be uninsured as households with a worker at a large employer. Despite efforts by Congress and the states to help small employers buy coverage, many...
Retiree Health Insurance: Gaps in Coverage and Availability
GAO-02-178T: Published: Nov 1, 2001. Publicly Released: Nov 1, 2001.
In 1999, about 10 million Americans aged 55 and older relied on employer-sponsored health benefits until they became eligible for Medicare or to pay for out-of-pocket expenses not covered by Medicare. However, the number of employers offering these benefits has declined considerably during the past decade. Despite the recent strong economy and the relatively low increases in health insurance premi...
Medicare Part B Drugs: Program Payments Should Reflect Market Prices
GAO-01-1142T: Published: Sep 21, 2001. Publicly Released: Sep 21, 2001.
The pricing of Medicare's part B-covered prescription drugs--largely drugs that cannot be administered by patients themselves--has been under scrutiny for years. Most of the part B drugs with the highest Medicare payments and billing volume fall into three categories: those that are billed for by physicians and typically provided in a physician office setting, those that are billed for by pharmacy...
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...