Health care cost control (51 - 60 of 321 items)
Retired Coal Miners' Health Benefit Funds: Financial Challenges Continue
GAO-02-243: Published: Apr 18, 2002. Publicly Released: May 20, 2002.
More than 100,000 retired coal miners and their spouses and dependents in 1992 faced a potential decrease in their employment-related health insurance coverage or loss of such coverage altogether. Some former employers had stopped mining coal or gone out of business and were no longer contributing to the United Mine Workers of America (UMWA) retiree benefit funds. To ensure that these individuals...
Medicare: Financial Outlook Poses Challenges for Sustaining Program and Adding Drug Coverage
GAO-02-643T: Published: Apr 17, 2002. Publicly Released: Apr 17, 2002.
The lack of outpatient prescription drug coverage may leave Medicare's most vulnerable beneficiaries with high out-of-pocket costs. Recent estimates suggest that, at any given time, more than a third of Medicare beneficiaries lack prescription drug coverage. The rest have some coverage through various sources--most commonly employer-sponsored health plans. Recent evidence indicates that this cover...
Medicare Outpatient Drugs: Program Payments Should Better Reflect Market Prices
GAO-02-531T: Published: Mar 14, 2002. Publicly Released: Mar 14, 2002.
In some cases, Medicare pays significantly more for covered outpatient drugs than the actual costs to the physicians and pharmacy suppliers. Attempts to reduce these payments have been met with provider claims that overpayments for the drugs are needed to cover underpayments for administering or delivering them. Medicare's method for establishing drug payments is flawed. Medicare pays 95 percent o...
Medigap: Current Polices Contain Coverage Gaps, Undermine Cost Control Incentives
GAO-02-533T: Published: Mar 14, 2002. Publicly Released: Mar 14, 2002.
Medicare provides valuable and extensive health care coverage for 40 million elderly and disabled beneficiaries. Nevertheless, significant gaps leave some beneficiaries vulnerable to sizeable out-of-pocket expenses. Medicare provides no limit on out-of-pocket spending and no coverage for most outpatient prescription drugs. Most beneficiaries have supplemental coverage that helps to fill Medicare c...
Medicare Physician Payments: Spending Targets Encourage Fiscal Discipline, Modifications Could Stabilize Fees
GAO-02-441T: Published: Feb 14, 2002. Publicly Released: Feb 14, 2002.
Congress implemented a physician fee schedule and a fee update formula to moderate spending growth relative to specified Medicare spending targets. These spending targets increase annually to reflect higher costs for physician services, the growth in the overall economy, and changes in the number of Medicare beneficiaries. Physician fees are adjusted for changes in the costs of providing services...
Medicare: Payments for Covered Outpatient Drugs Exceed Providers' Costs
GAO-01-1118: Published: Sep 21, 2001. Publicly Released: Sep 21, 2001.
Although physicians and other health care providers acknowledge that they can buy drugs for prices lower than Medicare payments, they contend that they need drug payments in excess of their actual costs to compensate for inadequate or nonexistent Medicare payments for administrating the drugs. Physicians are able to obtain Medicare-covered drugs at prices significantly below current Medicare payme...
Skilled Nursing Facilities: Services Excluded From Medicare's Daily Rate Need to be Reevaluated
GAO-01-816: Published: Aug 22, 2001. Publicly Released: Aug 22, 2001.
Congress and the Health Care Financing Administration recognized that certain services needed to be excluded from the skilled nursing facility (SNF) prospective payment system (PPS) rate to help ensure beneficiary access to appropriate care and to financially protect the SNFs that take care of high-cost patients. The criteria used to identify services--high cost, infrequently provided during a SNF...
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...
Prescription Drugs: Drug Company Programs Help Some People Who Lack Coverage
GAO-01-137: Published: Nov 16, 2000. Publicly Released: Nov 16, 2000.
As Congress considers Medicare beneficiaries' access to prescription drug coverage, there is increased interest in the range of options available to help vulnerable populations obtain access to needed medications. Patient assistance programs, offered voluntarily by drug companies, are generally designed to provide prescription drugs to low-income persons who lack drug coverage. These programs typi...
Medicare: More Beneficiaries Use Hospice but for Fewer Days of Care
HEHS-00-182: Published: Sep 18, 2000. Publicly Released: Sep 18, 2000.
Pursuant to a congressional request, GAO provided information on the Medicare hospice benefit, focusing on: (1) the patterns and trends in hospice use by Medicare beneficiaries; (2) factors that affect the use of the hospice benefit; and (3) the availability of hospice providers to serve the needs of Medicare beneficiaries.GAO noted that: (1) the number of Medicare beneficiaries choosing hospice s...