Medical services rates (61 - 70 of 200 items)
Medicare: Better Information Can Help Ensure That Refinements to BBA Reforms Lead to Appropriate Payments
T-HEHS-00-14: Published: Oct 1, 1999. Publicly Released: Oct 1, 1999.
Pursuant to a congressional request, GAO discussed the effects of the Balanced Budget Act of 1997 (BBA) on the Medicare program, focusing on the effects on three providers of post-acute care services--home health agencies (HHA), skilled nursing facilities (SNF), and providers of outpatient rehabilitation therapy--and on the health plans participating in the Medicare Choice program.GAO noted that:...
Skilled Nursing Facilities: Medicare Payments Need to Better Account for Nontherapy Ancillary Cost Variation
HEHS-99-185: Published: Sep 30, 1999. Publicly Released: Sep 30, 1999.
Pursuant to a congressional request, GAO provided information on the Medicare payments for skilled nursing facilities' (SNF) services under the new prospective payment system (PPS), focusing on: (1) whether the SNF payment rates incorporate the costs of nontherapy ancillary services; and (2) an analysis of the PPS design and nontherapy ancillary cost variation to assess whether payments are distri...
HCFA: Medicare Program--Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2000 Rates
OGC-99-58: Published: Aug 13, 1999. Publicly Released: Aug 13, 1999.
Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on changes to the hospital inpatient prospective payment systems and fiscal year 2000 rates. GAO noted that: (1) the final rule would revise the Medicare hospital inpatient prospective payment systems for operating costs and capital-related costs to implement changes arising from HCFA's c...
Medicare+Choice: Reforms Have Reduced, but Likely Not Eliminated, Excess Plan Payments
HEHS-99-144: Published: Jun 18, 1999. Publicly Released: Jun 22, 1999.
Pursuant to a congressional request, GAO reviewed concerns surrounding the Balanced Budget Act's (BBA) health plan payment changes, focusing on: (1) the extent to which health plans provide additional benefits and whether they could continue to provide additional benefits if payments were reduced; (2) the evidence regarding managed care's effect on Medicare spending; and (3) whether BBA provisions...
Medicare+Choice: Impact of 1997 Balanced Budget Act Payment Reforms on Beneficiaries and Plans
T-HEHS-99-137: Published: Jun 9, 1999. Publicly Released: Jun 9, 1999.
Pursuant to a congressional request, GAO discussed on the impact of payment reforms in the Balanced Budget Act of 1997 (BBA) on the Medicare Choice program.GAO noted that: (1) the net effect of BBA payment revisions has been to reduce but not fully eliminate excess payments to health plans; (2) some of the provisions, such as the reduced annual updates, have already been implemented, while others,...
Medicare: Access to Home Oxygen Largely Unchanged; Closer HCFA Monitoring Needed
HEHS-99-56: Published: Apr 5, 1999. Publicly Released: Apr 5, 1999.
Pursuant to a legislative requirement, GAO provided information on Medicare beneficiaries' access to home oxygen equipment, focusing on: (1) changes in access to home oxygen for Medicare patients since the payment reduction mandated by the Balanced Budget Act (BBA) of 1997 took effect; and (2) actions taken by the Health Care Financing Administration (HCFA) to fulfill the BBA requirements and resp...
Medicare Physician Payments: Need to Refine Practice Expense Values During Transition and Long Term
HEHS-99-30: Published: Feb 24, 1999. Publicly Released: Feb 24, 1999.
Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) ongoing efforts to develop resource-based practice expense relative value units (RVUs), focusing on: (1) whether the new methodology is an acceptable approach for revising Medicare's fee schedule; (2) questions about the data, assumptions, and adjustments underlying the new methodology that need to...
Medicare Managed Care: Payment Rates, Local Fee-for-Service Spending, and Other Factors Affect Plans' Benefit Packages
HEHS-99-9R: Published: Oct 9, 1998. Publicly Released: Oct 9, 1998.
Pursuant to a congressional request, GAO provided information on Medicare's health maintenance organizations (HMO), focusing on: (1) the key differences between Medicare's traditional fee-for-service (FFS) and managed care programs; (2) how Medicare historically set the monthly capitation rates paid to managed care plans and why these rates varied among counties; (3) how the Balanced Budget Act of...
Medicare: Interim Payment System for Home Health Agencies
T-HEHS-98-234: Published: Aug 6, 1998. Publicly Released: Aug 6, 1998.
GAO discussed: (1) the rise in Medicare spending for home health services and the reasons for this growth; (2) the objectives of the home health interim payment system enacted by the Balanced Budget Act of 1997; and (3) concerns about the level and distribution of home health payments.GAO noted that: (1) a well-designed prospective payment system will provide the Medicare program with the best mea...
Health Financing and Systems Issues: Issue Area Plan for Fiscal Years 1999-2001
IAP-98-13: Published: Jun 1, 1998. Publicly Released: Jun 1, 1998.
GAO provided information on its Health Financing and Systems issue area plan for fiscal years 1999-2001.GAO plans to examine: (1) how effectively the Health Care Financing Administration is managing Medicare's fee-for-service and managed care components--particularly the implementation of recent legislative reforms; (2) how payment and pricing reforms will be implemented and what effect they might...