Managed health care (51 - 60 of 63 items)
Health Financing and Public Health Issue Area: Active Assignments
AA-96-14(1): Published: Jan 2, 1996. Publicly Released: Jan 2, 1996.
GAO provided information on its active assignments in the Health Financing and Public Health issue area as of January 2, 1996...
Medicare Managed Care: Growing Enrollment Adds Urgency to Fixing HMO Payment Problem
HEHS-96-21: Published: Nov 8, 1995. Publicly Released: Nov 8, 1995.
Pursuant to a congressional request, GAO reviewed Medicare payments to health maintenance organizations (HMO), focusing on: (1) current trends in Medicare beneficiary enrollment in HMO; (2) flaws in Medicare's rate-setting method that prevent it from realizing potential savings from HMO; and (3) the Health Care Financing Administration's (HCFA) efforts to test HMO payment reforms.GAO found that: (...
Health Insurance Portability: Reform Could Ensure Continued Coverage for Up to 25 Million Americans
HEHS-95-257: Published: Sep 19, 1995. Publicly Released: Sep 19, 1995.
Pursuant to a congressional request, GAO provided information on: (1) the protections offered by current state and federal health insurance portability reforms; (2) the number of people who could be affected by broader national portability standards; and (3) other issues related to the design of national portability standards.GAO found that: (1) although current federal and state laws have improve...
Employer-Based Health Plans: Issues, Trends, and Challenges Posed by ERISA
HEHS-95-167: Published: Jul 25, 1995. Publicly Released: Jul 25, 1995.
Pursuant to congressional requests, GAO provided information on the: (1) Employee Retirement Income Security Act's (ERISA) relationship to the current system of employer-based health coverage; (2) implications of the trend toward employer self-funding on the oversight of employees' health care coverage; (3) kinds of state actions preempted by ERISA; and (4) advantages of ERISA preemption to employ...
Medicare Managed Care: Enrollment Growth Underscores Need to Revamp HMO Payment Methods
T-HEHS-95-207: Published: Jul 12, 1995. Publicly Released: Jul 12, 1995.
Pursuant to a congressional request, GAO discussed the: (1) recent trends in Medicare beneficiary enrollment in health maintenance organizations (HMO); (2) obstacles that are preventing Medicare from realizing potential savings from HMO; (3) strategies that will enable Medicare to realize HMO savings; and (4) Health Care Financing Administration's (HCFA) efforts to test HMO payment reforms. GAO no...
Medicare and Medicaid: Opportunities to Save Program Dollars by Reducing Fraud and Abuse
T-HEHS-95-110: Published: Mar 22, 1995. Publicly Released: Mar 22, 1995.
GAO discussed Medicare and Medicaid health care cost savings. GAO noted that: (1) Medicare and Medicaid are overwhelmed by numerous profiteers who abuse and defraud the programs; (2) the fee-for-service system gives providers strong incentives to overprovide and overbill for services; (3) the programs have weak fraud and abuse controls to detect questionable billing practices, and few limits on wh...
Health Security Act: Analysis of Veterans' Health Care Provisions
HEHS-94-205FS: Published: Jul 15, 1994. Publicly Released: Jul 15, 1994.
GAO provided information on health care reform legislation, focusing on the proposed reforms to the veterans health care system.GAO found that: (1) although many legislative proposals have been introduced to reform the nation's health care system, only the Health Security Act contains specific proposals for restructuring the veterans' health care system; (2) the Health Security Act would authorize...
Health Care Reform: Proposals Have Potential to Reduce Administrative Costs
HEHS-94-158: Published: May 31, 1994. Publicly Released: Jun 29, 1994.
Pursuant to a congressional request, GAO reviewed how various health care reform proposals would affect administrative functions in a single-payer or managed competition health insurance system.GAO found that: (1) each health care proposal would shift many private insurance-related administrative functions to the public sector, reduce administrative costs, and improve access and efficiency; (2) al...
Veterans' Health Care: Efforts to Make VA Competitive May Create Significant Risks
T-HEHS-94-197: Published: Jun 29, 1994. Publicly Released: Jun 29, 1994.
GAO discussed the potential effects of health reforms on veterans' health care, focusing on the: (1) legal and structural barriers that could limit the Department of Veterans Affairs' (VA) ability to restructure its health care facilities into managed care plans and compete with private-sector health plans; (2) extent to which the Health Security Act would overcome those barriers; and (3) potentia...
Managed Health Care: Effect on Employers' Costs Difficult to Measure
T-HEHS-94-91: Published: Feb 2, 1994. Publicly Released: Feb 2, 1994.
GAO discussed managed health care and its effect on employers' health care costs. GAO noted that: (1) certain managed care plans' potential for providing care at lower cost depends on the plans' controls on price and the use of services and the incentives for consumers and physicians; (2) group and staff health maintenance organizations (HMO) have the most potential for cost savings; (3) the effec...