Medical services rates (51 - 60 of 200 items)
Medicare Home Health Care: Prospective Payment System Could Reverse Recent Declines in Spending
HEHS-00-176: Published: Sep 8, 2000. Publicly Released: Sep 8, 2000.
Pursuant to a congressional request, GAO provided information on Medicare home health care's recent declines in spending, focusing on: (1) the declines in service use underlying the changes in spending; (2) the extent of the changes in use across beneficiaries, home health agencies (HHA), and locations; and (3) identify any implications these new patterns of home health use have for the impact of...
Medicare+Choice: Plan Withdrawals Indicate Difficulty of Providing Choice While Achieving Savings
HEHS-00-183: Published: Sep 7, 2000. Publicly Released: Sep 7, 2000.
Pursuant to a congressional request, GAO reviewed health care plans' withdrawal from the Medicare Choice program, focusing on the: (1) geographic distribution and the distribution among plans of enrollees affected by the recent plan withdrawals; (2) factors associated with plans that terminated or reduced their participation in the program; and (3) likely role of payment rates in affecting plans'...
Nursing Homes: Aggregate Medicare Payments Are Adequate Despite Bankruptcies
T-HEHS-00-192: Published: Sep 5, 2000. Publicly Released: Sep 5, 2000.
Pursuant to a congressional request, GAO discussed the causes of the bankruptcies of large corporations owning nursing homes and the implications for nursing home residents, focusing on: (1) the adequacy of Medicare's payment rates for skilled nursing services furnished in nursing homes; (2) the relationship between the changes wrought by the Balanced Budget Act and recent nursing home bankruptcie...
Medicare+Choice: Payments Exceed Cost of Fee-for-Service Benefits, Adding Billions to Spending
HEHS-00-161: Published: Aug 23, 2000. Publicly Released: Aug 23, 2000.
Pursuant to a congressional request, GAO reviewed Medicare Choice program payment issues, focusing on: (1) whether program spending for Medicare Choice plan enrollees has exceeded what Medicare-covered care for these beneficiaries would have cost in the fee-for-service (FFS) Medicare program; and (2) the extent to which payments to individual plans differ from expected FFS costs.GAO noted that: (1...
HCFA: Medicare Program--Provisions of the Balanced Budget Refinement Act of 1999 and Hospital Inpatient Payments and Rates and Costs of Graduate Medical Education
OGC-00-57: Published: Aug 15, 2000. Publicly Released: Aug 15, 2000.
Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on hospital inpatient payments and rates and costs of graduate medical education. GAO noted that: (1) the interim rule implements provisions of the Medicare, Medicaid, and State Children's Health Insurance Program Balanced Budget Refinement Act of 1999 relating to Medicare payments to hos...
Health Care Financing Administration: Medicare Program--Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2001 Rates
OGC-00-56: Published: Aug 15, 2000. Publicly Released: Aug 15, 2000.
Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on hospital inpatient payment systems and rates. GAO noted that: (1) the final rule revises the Medicare hospital inpatient prospective payment systems for operating costs and capital-related costs to implement changes arising from HCFA's continuing experience with the systems; and (2) HC...
Rural Ambulances: Medicare Fee Schedule Payments Could Be Better Targeted
HEHS-00-115: Published: Jul 17, 2000. Publicly Released: Aug 3, 2000.
Pursuant to a congressional request, GAO reviewed Medicare payments for ambulance services in rural areas, focusing on: (1) the challenges faced by rural ambulance providers; (2) how the upcoming fee schedule will affect rural providers relative to their current situation; and (3) what factors have affected claim denial rates for ambulance services.GAO noted that: (1) because many rural ambulance...
Medicare: Refinements Should Continue to Improve Appropriateness of Provider Payments
T-HEHS-00-160: Published: Jul 19, 2000. Publicly Released: Jul 19, 2000.
Pursuant to a congressional request, GAO discussed the effects of recent Medicare payment reforms, focusing on the Balanced Budget Act of 1997 (BBA) payment reforms affecting home health agencies, skilled nursing facilities (SNF), and the health plans in Medicare's managed care program, known as Medicare Choice.GAO noted that: (1) the reactions by providers serving Medicare beneficiaries to BBA an...
Medicare Reform: Leading Proposals Lay Groundwork, While Design Decisions Lie Ahead
T-HEHS/AIMD-00-103: Published: Feb 24, 2000. Publicly Released: Feb 24, 2000.
Pursuant to a congressional request, GAO discussed two leading proposals on Medicare reform: (1) the President's Plan to Modernize and Strengthen Medicare for the 21st Century; and (2) S. 1895, entitled the Medicare Preservation and Improvement Act of 1999, which is commonly referred to as the Breax-Frist proposal.GAO noted that: (1) the elements of restructuring of Medicare as proposed by the Pre...
Medicare: Program Reform and Modernization Are Needed But Entail Considerable Challenges
T-HEHS/AIMD-00-77: Published: Feb 8, 2000. Publicly Released: Feb 8, 2000.
Pursuant to a congressional request, GAO discussed efforts to reform the administration, structure, and financing of the Medicare Program.GAO noted that: (1) in addition to its sizable financial imbalance, Medicare is outmoded from a programmatic perspective; (2) to address the need for an updated benefit package and adequate tools to moderate program spending, proposals have been advanced that in...