Hospitals (11 - 20 of 98 items)
Medicare: Higher Use of Costly Prostate Cancer Treatment by Providers Who Self-Refer Warrants Scrutiny
GAO-13-525: Published: Jul 19, 2013. Publicly Released: Aug 1, 2013.
The number of Medicare prostate cancer-related intensity-modulated radiation therapy (IMRT) services performed by self-referring groups increased rapidly, while declining for non-self-referring groups from 2006 to 2010. Over this period, the number of prostate cancer-related IMRT services performed by self-referring groups increased from about 80,000 to 366,000. Consistent with that growth, expend...
Medicare: Information on Highest-Expenditure Part B Drugs
GAO-13-739T: Published: Jun 28, 2013. Publicly Released: Jun 28, 2013.
Medicare expenditures for Part B drugs in 2010 were concentrated among relatively few drugs. The 55 highest-expenditure Part B drugs represented $16.9 billion in spending, or about 85 percent of all Medicare spending on Part B drugs, and the 10 highest-expenditure drugs accounted for about 45 percent of all Part B drug spending in 2010. Most of these drugs were under patent and could be purchased...
Indian Health Service: Capping Payment Rates for Nonhospital Services Could Save Millions of Dollars for Contract Health Services
GAO-13-272: Published: Apr 11, 2013. Publicly Released: Apr 11, 2013.
The Indian Health Service's (IHS) federal contract health services (CHS) programs primarily paid physicians at their billed charges, which were significantly higher than what Medicare and private insurers would have paid for the same services. IHS's policy states that federal CHS programs should purchase services from contracted providers at negotiated, reduced rates. However, of the almost $63 mi...
Electronic Health Records: Number and Characteristics of Providers Awarded Medicaid Incentive Payments for 2011
GAO-13-146R: Published: Dec 13, 2012. Publicly Released: Dec 13, 2012.
In summary, 1,964 hospitals and 45,962 professionals were awarded a total of approximately $2.7 billion in Medicaid EHR incentive payments for 2011. These 1,964 hospitals, which represented 39 percent of the 5,013 eligible hospitals, were awarded a total of $1.7 billion in Medicaid EHR incentive payments for 2011. While the amount of Medicaid EHR incentive payments awarded to each hospital ranged...
Medicare: Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions
GAO-12-966: Published: Sep 28, 2012. Publicly Released: Oct 31, 2012.
From 2004 through 2010, the number of self-referred and non-self-referred advanced imaging services--magnetic resonance imaging (MRI) and computed tomography (CT) services--both increased, with the larger increase among self-referred services. For example, the number of self-referred MRI services increased over this period by more than 80 percent, compared with an increase of 12 percent for non-se...
Medicaid: States Reported Billions More in Supplemental Payments in Recent Years
GAO-12-694: Published: Jul 20, 2012. Publicly Released: Aug 20, 2012.
States reported $32 billion in Medicaid supplemental payments during fiscal year 2010, but the exact amount of supplemental payments is unknown because state reporting was incomplete. On expenditure reports used to obtain federal funds filed with the Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS), states reported the following:A total of $17.6 bi...
Medicare: Implementation of Financial Incentive Programs under Federal Fraud and Abuse Laws
GAO-12-355: Published: Mar 30, 2012. Publicly Released: Apr 30, 2012.
Certain financial incentive programs are permitted within the framework of federal fraud and abuse laws, but stakeholders GAO spoke with reported that the laws, regulations, and agency guidance have created challenges for program design and implementation. The Stark law and anti-kickback statute, which restrict financial relationships among providers, have statutory and regulatory exceptions and s...
Federal Antitrust Policy: Stakeholders' Perspectives Differed on the Adequacy of Guidance for Collaboration among Health Care Providers
GAO-12-291R: Published: Mar 16, 2012. Publicly Released: Apr 16, 2012.
Stakeholdershealth care industry groups and experts in antitrust lawhad different perspectives on the adequacy of three key aspects of antitrust guidance for health care provider collaboration. First, stakeholders perspectives differed on the sufficiency of guidance on clinical integration, which involves integrating clinical activities across providers in a collaborative arrange...
Medicare: Lack of Price Transparency May Hamper Hospitals' Ability to Be Prudent Purchasers of Implantable Medical Devices
GAO-12-126: Published: Jan 13, 2012. Publicly Released: Feb 3, 2012.
From 2004 through 2009, expenditures for hospital IMD procedures increased from $16.1 billion to $19.8 billion, an increase of 4.3 percent per yeara rate equal to that of Medicare spending for other hospital procedures. While cardiac and orthopedic procedures accounted for nearly all IMD-related expenditures, orthopedic procedures accounted for most of the increase in such expenditures durin...
Private Health Insurance: Research on Competition in the Insurance Industry
GAO-09-864R: Published: Jul 31, 2009. Publicly Released: Aug 31, 2009.
Health care providers and members of Congress have raised concerns that consolidation in the private health insurance industry may be resulting in less competitive markets and contributing to rising health insurance rates paid by consumers and employers. However, measuring the extent of changes in market competition over time or the effects of changes is challenging. In particular, reliable, longi...