Managed health care (41 - 50 of 63 items)
Medicare HMOs: Potential Effects of a Limited Enrollment Period Policy
HEHS-97-50: Published: Feb 28, 1997. Publicly Released: Mar 5, 1997.
Pursuant to a congressional request, GAO reviewed how a limited enrollment period would affect the Medicare program, private health plans, beneficiaries, and employers who provide Medicare supplemental benefits to retirees, focusing on: (1) the growth of Medicare's managed care program; (2) employers' attempts to administer their respective benefits seasons; (3) taxpayer savings measured against b...
Medicaid: States' Efforts to Educate and Enroll Beneficiaries in Managed Care
HEHS-96-184: Published: Sep 17, 1996. Publicly Released: Oct 29, 1996.
Pursuant to a congressional request, GAO provided information on state efforts to enroll Medicaid beneficiaries in managed care, focusing on: (1) the role of managed care organizations (MCO) in marketing and expanding managed care participation; (2) the types of marketing and enrollment abuses that have occurred and states' efforts to curb these abuses and ensure that beneficiaries are informed ab...
Prescription Drug Pricing: Implications for Retail Pharmacies
T-HEHS-96-216: Published: Sep 19, 1996. Publicly Released: Sep 19, 1996.
GAO discussed the implications of prescription drug pricing for retail pharmacies, focusing on the: (1) changes in the process of getting prescription drugs from manufacturers to patients; and (2) consequences for and response of retail pharmacies to these changes. GAO noted that: (1) health insurers have used their consolidated buying power to obtain drug discounts not available to retail pharmac...
Health Financing and Systems Issue Area: Active Assignments
AA-96-15(4): Published: Sep 3, 1996. Publicly Released: Sep 3, 1996.
GAO provided information on its active assignments in the Health Financing and Systems issue area as of September 3, 1996...
Health Financing and Systems Issue Area Plan--Fiscal Years 1997-99
IAP-96-26: Published: Sep 1, 1996. Publicly Released: Sep 1, 1996.
GAO provided information on its Health Financing and Systems issue area plan for fiscal years 1997 to 1999.GAO plans to: (1) review the Health Care Financing Administration's efforts to collect payments from other insurers in the Medicare Secondary Payer program; (2) review states' ability to monitor managed care plans' financial solvency and administrative costs; (3) review managed care programs...
Medicaid Managed Care: Serving the Disabled Challenges State Programs
HEHS-96-136: Published: Jul 31, 1996. Publicly Released: Jul 31, 1996.
Pursuant to a congressional request, GAO examined state efforts to include disabled Medicaid beneficiaries in prepaid managed care programs, focusing on the: (1) extent to which states are implementing Medicaid prepaid managed care programs for disabled beneficiaries; and (2) steps that have been taken to safeguard the interests of the stakeholder groups.GAO found that: (1) few states have signifi...
Health Systems Issue Area: Active Assignments
AA-96-15(2): Published: Apr 6, 1996. Publicly Released: Apr 6, 1996.
GAO provided information on its active assignments in its Health Systems issue area as of April 6, 1996...
Medicare HMOs: Rapid Enrollment Growth Concentrated in Selected States
HEHS-96-63: Published: Jan 18, 1996. Publicly Released: Feb 20, 1996.
Pursuant to a congressional request, GAO provided information on the: (1) number of Medicare beneficiaries enrolling in health maintenance organizations (HMO); and (2) factors that influence beneficiaries' decisions to enroll in HMO.GAO found that: (1) about 2.8 million Medicare beneficiaries are enrolled in risk-contract HMO and another 2 percent are enrolled in cost-reimbursement HMO; (2) the nu...
Medicare: Millions Can Be Saved by Screening Claims for Overused Services
HEHS-96-49: Published: Jan 30, 1996. Publicly Released: Feb 9, 1996.
GAO provided information on Medicare payments for unnecessary medical services, focusing on the: (1) extent to which Medicare contractors employ medical necessity prepayment screens for procedures that are likely to be overused; (2) potential impact of autoadjudicated prepayment screens on Medicare spending; and (3) federal government's role in reducing overused medical procedures billed to Medica...
Medicaid: Spending Pressures Spur States Toward Program Restructuring
T-HEHS-96-75: Published: Jan 18, 1996. Publicly Released: Jan 18, 1996.
GAO discussed how states are addressing rising Medicaid costs, focusing on the: (1) federal mandates that have led to Medicaid cost growth; (2) states' use of section 1115 waivers for managed care programs; and (3) states' experiences with section 1115 managed care programs. GAO noted that: (1) federal mandates, medical price inflation, and higher provider reimbursements have contributed to rising...