Medicaid (51 - 60 of 130 items)
Medicare HMOs: HCFA Can Promptly Eliminate Hundreds of Millions in Excess Payments
HEHS-97-16: Published: Apr 25, 1997. Publicly Released: May 13, 1997.
Pursuant to a congressional request, GAO provided information on Medicare's rate-setting method for paying risk contract health maintenance organizations (HMO), focusing on: (1) the conditions under which Medicare's method can yield payment rates that are too high; and (2) a practical improvement to Medicare's method directed at the problems fostering excess payments.GAO noted that: (1) contrary t...
Medicaid: Graduate Medical Education Payments
HEHS-97-77R: Published: Mar 3, 1997. Publicly Released: Apr 2, 1997.
Pursuant to a congressional request, GAO provided information on: (1) existing studies that estimate overall Medicaid expenditures for graduate medical education (GME); (2) the amount of Medicaid GME payments for the 10 states with the largest overall Medicaid expenditures, and the basis for determining these payments; and (3) how Medicaid and Medicare coordinate their GME payments to avoid duplic...
Employment-Based Health Insurance: Costs Increase and Family Coverage Decreases
HEHS-97-35: Published: Feb 24, 1997. Publicly Released: Mar 21, 1997.
Pursuant to a congressional request, GAO provided information on the decline in employment-based health insurance, focusing on: (1) recent trends in employment-based private health insurance, particularly for family coverage; (2) any corresponding changes in the number of adults and children with private insurance coverage as dependents; and (3) the potential effect of these changes, if any, on pu...
Medicaid: Recent Spending Experience and the Administration's Proposed Program Reform
T-HEHS-97-94: Published: Mar 11, 1997. Publicly Released: Mar 11, 1997.
GAO discussed recent Medicaid spending trends and their potential implications for future outlays, focusing on: (1) key factors that explain the Medicaid 3.3-percent growth rate in fiscal year 1996; and (2) the administration's proposal to contain Medicaid cost growth through decreases in disproportionate share hospital (DSH) payments and per capita caps, and to increase state flexibility.GAO note...
Medicare: Home Health Cost Growth and Administration's Proposal for Prospective Payment
T-HEHS-97-92: Published: Mar 5, 1997. Publicly Released: Mar 5, 1997.
GAO discussed Medicare's home health care benefit and the administration's forthcoming legislative proposals related to this Medicare benefit.GAO noted that: (1) Medicare's home health care costs have grown because a larger portion of beneficiaries use this benefit than in the past and the number of services used by each beneficiary has more than doubled; (2) a combination of factors led to the in...
Medicare Post-Acute Care: Home Health and Skilled Nursing Facility Cost Growth and Proposals for Prospective Payment
T-HEHS-97-90: Published: Mar 4, 1997. Publicly Released: Mar 4, 1997.
GAO discussed Medicare's skilled nursing facility (SNF) and home health care benefits and the administration's forthcoming legislative proposals related to them.GAO noted that: (1) Medicare's SNF costs have grown primarily because a larger portion of beneficiaries use SNFs than in the past and because of a large increase in the provision of ancillary services; (2) for home health care costs, both...
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...