Health care cost control (41 - 50 of 321 items)
Medicare Home Health: Payments to Most Freestanding Home Health Agencies More Than Cover Their Costs
GAO-04-359: Published: Feb 27, 2004. Publicly Released: Feb 27, 2004.
Under Medicare's home health prospective payment system (PPS), home health agencies (HHA) are paid a fixed amount, adjusted for differences in individual patients' expected care needs, for providing an episode (up to 60 days) of care. For this payment, HHAs provide therapy, skilled nursing, medical social service, and aide visits to patients in their homes. GAO previously reported that PPS payment...
Medicare: Financial Challenges and Considerations for Reform
GAO-03-577T: Published: Apr 10, 2003. Publicly Released: Apr 10, 2003.
We are pleased to be here today as Congress examines Medicare's financial health and consider the budgetary and economic challenges presented by an aging society. The Comptroller General has been particularly attentive to the sustainability challenges faced by the nation's two largest entitlement programs--Medicare and Social Security--for more than a decade since he served as a public trustee for...
Medicare: Observations on Program Sustainability and Strategies to Control Spending on Any Proposed Drug Benefit
GAO-03-650T: Published: Apr 9, 2003. Publicly Released: Apr 9, 2003.
The House Committee on Ways and Means is holding a hearing on modernizing Medicare and integrating prescription drugs into the program. There are growing concerns about gaps in the Medicare program, most notably the lack of outpatient prescription drug coverage, which may leave Medicare's most vulnerable beneficiaries with high out-of-pocket costs. At the same time, Medicare already faces a huge p...
Medicare Trust Funds Actuarial Estimates: Efforts Have Been Made to Improve Internal Control over Projection Process but Some Weaknesses Remain
GAO-03-247R: Published: Mar 4, 2003. Publicly Released: Mar 4, 2003.
Medicare spending growth remains one of the most pressing and complex issues facing the Congress and the nation. During calendar year 2001, the most recent year for which complete data were available at the time of our review, over 40 million Medicare enrollees received $240.9 billion in benefits from the trust funds maintained for Hospital Insurance and Supplementary Medical Insurance, Medicare's...
Skilled Nursing Facilities: Medicare Payments Exceed Costs for Most but Not All Facilities
GAO-03-183: Published: Dec 31, 2002. Publicly Released: Dec 31, 2002.
This report addresses (1) the relationship between Medicare skilled nursing facility (SNF) payments and the costs of treating Medicare patients in freestanding SNFs, as well as the effect of Medicare SNF payments on the financial condition of these facilities, and (2) the relationship between Medicare SNF payments and the costs of treating patients in hospital-based SNFs, as well as the factors th...
VA Health Care: Expanded Eligibility Has Increased Outpatient Pharmacy Use and Expenditures
GAO-03-161: Published: Nov 8, 2002. Publicly Released: Nov 8, 2002.
The Department of Veterans Affairs (VA) spent about $3.0 billion on its outpatient pharmacy benefit in fiscal year 2001. After VA implemented the Veterans' Health Care Eligibility Reform Act in 1999, more veterans could use VA outpatient care, including the pharmacy benefit, than before. Increased eligibility contributed to a doubling of the number of Priority 7 veterans using VA health care. Prio...
Medicare Hospital Payments: Refinements Needed to Better Account for Geographic Differences in Wages
GAO-02-963: Published: Sep 30, 2002. Publicly Released: Sep 30, 2002.
The Medicare program's prospective payment system (PPS) for inpatient hospital services provides incentives for hospitals to operate efficiently by paying them a predetermined, fixed amount for each inpatient hospital stay regardless of the actual costs incurred in providing the care. Although the fixed amount is based on national average costs, actual per stay payments vary widely across hospital...
Skilled Nursing Facilities: Providers Have Responded to Medicare Payment System By Changing Practices
GAO-02-841: Published: Aug 23, 2002. Publicly Released: Aug 23, 2002.
In 1998, the Health Care Financing Administration implemented a prospective payment system (PPS) for skilled nursing facility (SNF) services provided to Medicare beneficiaries. PPS is intended to control the growth in Medicare spending for skilled nursing and rehabilitative services that SNFs provide. Two years after the implementation of PPS, the mix of patients across the categories of payment g...
Medicare Hospital and Physician Payments: Geographic Cost Adjustments Important to Preserve Beneficiary Access to Services
GAO-02-968T: Published: Jul 23, 2002. Publicly Released: Jul 23, 2002.
This testimony discusses Medicare program payment adjustments to hospitals and physicians that account for geographic differences in costs. Because Medicare's hospital and physician payment systems are based on national rates, these geographic cost adjustments are essential to account for costs beyond providers' control and to ensure that beneficiaries have adequate access to services. If these ad...
Medicare: Challenges Remain in Setting Payments for Medical Equipment and Supplies and Covered Drugs
GAO-02-833T: Published: Jun 12, 2002. Publicly Released: Jun 12, 2002.
Medicare has paid higher than market rates for various medical equipment and supplies and often considerably higher than provider acquisition costs for Medicare-covered outpatient drugs. Congress has enacted a series of legislative changes affecting payment methods and payment adjustment authority for medical equipment and supplies and outpatient drugs since the late 1980s. However, progress in se...