Managed health care (11 - 20 of 63 items)
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...
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...
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 and Medicaid: Implementing State Demonstrations for Dual Eligibles Has Proven Challenging
HEHS-00-94: Published: Aug 18, 2000. Publicly Released: Sep 18, 2000.
Pursuant to a congressional request, GAO reviewed states' initiatives to enroll dual eligibles (beneficiaries who qualify for both Medicare and Medicaid benefits) into one managed care plan, focusing on: (1) the status and key features of state initiatives focusing on: (1) the status and key features of state initiatives to integrate care for dual-eligible beneficiaries; and (2) factors that have...
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+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...
Medicare: Refinements Should Continue to Improve Appropriateness of Provider Payments
T-HEHS-00-160: Published: Jul 19, 2000. Publicly Released: Jul 19, 2000.
Pursuant to a congressional request, GAO discussed the effects of recent Medicare payment reforms, focusing on the Balanced Budget Act of 1997 (BBA) payment reforms affecting home health agencies, skilled nursing facilities (SNF), and the health plans in Medicare's managed care program, known as Medicare Choice.GAO noted that: (1) the reactions by providers serving Medicare beneficiaries to BBA an...
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...
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 Reform: Leading Proposals Lay Groundwork, While Design Decisions Lie Ahead
T-HEHS/AIMD-00-103: Published: Feb 24, 2000. Publicly Released: Feb 24, 2000.
Pursuant to a congressional request, GAO discussed two leading proposals on Medicare reform: (1) the President's Plan to Modernize and Strengthen Medicare for the 21st Century; and (2) S. 1895, entitled the Medicare Preservation and Improvement Act of 1999, which is commonly referred to as the Breax-Frist proposal.GAO noted that: (1) the elements of restructuring of Medicare as proposed by the Pre...