Health care services (1 - 10 of 66 items)
Medicaid: Demographics and Service Usage of Certain High-Expenditure Beneficiaries
GAO-14-176: Published: Feb 19, 2014. Publicly Released: Feb 19, 2014.
In fiscal year 2009, states spent nearly a third (31.6 percent) of all Medicaid expenditures on the most expensive Medicaid-only beneficiaries, who were 4.3 percent of total Medicaid beneficiaries. States spent another third (33.1 percent) on all other Medicaid-only beneficiaries, who represented 81.2 percent of total Medicaid beneficiaries. Among dual eligible beneficiaries, a similar pattern exi...
Children's Health Insurance: Information on Coverage of Services, Costs to Consumers, and Access to Care in CHIP and Other Sources of Insurance
GAO-14-40: Published: Nov 21, 2013. Publicly Released: Dec 20, 2013.
In five selected states, GAO determined that the separate State Children's Health Insurance Program (CHIP) plans were generally comparable to the benchmark plans selected by states in 2012 as models for the benefits that will be offered through qualified health plans (QHP) in 2014. The plans were comparable in the services they covered and the services on which they imposed limits, although there...
Private Health Insurance: Research on Competition in the Insurance Industry
GAO-09-864R: Published: Jul 31, 2009. Publicly Released: Aug 31, 2009.
Health care providers and members of Congress have raised concerns that consolidation in the private health insurance industry may be resulting in less competitive markets and contributing to rising health insurance rates paid by consumers and employers. However, measuring the extent of changes in market competition over time or the effects of changes is challenging. In particular, reliable, longi...
Health Centers And Rural Clinics: State and Federal Implementation Issues for Medicaid's New Payment System
GAO-05-452: Published: Jun 17, 2005. Publicly Released: Jun 17, 2005.
The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) established a prospective payment system (PPS) for Medicaid payments to Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC), giving providers a financial incentive to operate efficiently. BIPA requires that BIPA PPS rates be adjusted for inflation and changes in scope of services. States a...
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...
Medical Savings Accounts: Results From Surveys of Insurers
HEHS-99-34: Published: Dec 31, 1998. Publicly Released: Dec 31, 1998.
Pursuant to a legislative requirement, GAO addressed the effects of medical savings accounts (MSA) on: (1) selection, including adverse selection; (2) health costs, including any new impact on premiums of individuals with comprehensive coverage; (3) use of preventive care; (4) consumer choice; (5) the scope of coverage on high-deductible plans purchased in conjunction with such accounts; and (6) o...
Medicare: Coverage of Pumps Used to Administer Intravenous Drugs
HEHS-99-16R: Published: Nov 16, 1998. Publicly Released: Dec 16, 1998.
Pursuant to a congressional request, GAO reviewed the advantages and disadvantages of providing Medicare coverage for disposable infusion pumps, focusing on: (1) the clinical benefits and limitations of disposable infusion pumps; (2) the factors that affect whether a durable or disposable infusion pump is less expensive to use for home infusion; (3) some Medicaid and private insurance plans' home...
Private Health Insurance: Employer Coverage Trends Signal Possible Decline in Access for 55- to 64-Year-Olds
T-HEHS-98-199: Published: Jun 25, 1998. Publicly Released: Jun 25, 1998.
Pursuant to a congressional request, GAO discussed access to health insurance by near-elderly Americans aged 55 to 64, focusing on the near elderly's: (1) health, employment, income, and health insurance status; (2) ability to obtain employer-based health insurance if they retire before they are eligible for Medicare; and (3) access to individually purchased coverage or employer-based continuation...
Private Health Insurance: Declining Employer Coverage May Affect Access for 55- to 64-Year-Olds
HEHS-98-133: Published: Jun 1, 1998. Publicly Released: Jun 18, 1998.
Pursuant to a congressional request, GAO reviewed the ability of Americans aged 55 to 64 to obtain health benefits through the private market--either employer-based or individually purchased, focusing on the near elderly's: (1) health, employment, income, and health insurance status; (2) ability to obtain employer-based health insurance if they retire before they are eligible for Medicare; and (3)...
Health Insurance Standards: Implications of New Federal Law for Consumers, Insurers, Regulators
T-HEHS-98-114: Published: Mar 19, 1998. Publicly Released: Mar 19, 1998.
Pursuant to a congressional request, GAO discussed the implementation of the private insurance market provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).GAO noted that: (1) although HIPAA gives people losing coverage a guarantee of access to coverage in the individual market, consumers attempting to exercise this right have been hindered in some states by carrier...