Patient care services (21 - 30 of 72 items)
Medicaid and CHIP: Most Physicians Serve Covered Children but Have Difficulty Referring Them for Specialty Care
GAO-11-624: Published: Jun 30, 2011. Publicly Released: Jun 30, 2011.
Medicaid and the Children's Health Insurance Program (CHIP)--two joint federal-state health care programs for certain low-income individuals--play a critical role in addressing the health care needs of children. The Children's Health Insurance Program Reauthorization Act of 2009 required GAO to study children's access to care under Medicaid and CHIP, including information on physicians' willingnes...
Medicare: Private Sector Initiatives to Bundle Hospital and Physician Payments for an Episode of Care
GAO-11-126R: Published: Jan 31, 2011. Publicly Released: Mar 2, 2011.
In recent years, we and other federal fiscal experts--including the Congressional Budget Office (CBO) and the Medicare Trustees--have noted the rise in Medicare spending and expressed concern that the program is unsustainable in its present form. Concerns about the rising cost of health care are particularly pressing in light of evidence that suggests that greater spending does not necessarily tra...
Health Care Delivery: Features of Integrated Systems Support Patient Care Strategies and Access to Care, but Systems Face Challenges
GAO-11-49: Published: Nov 16, 2010. Publicly Released: Nov 16, 2010.
Health care delivery in the United States often lacks coordination and communication across providers and settings. This fragmentation can lead to poor quality of care, medical errors, and higher costs. Providers have formed integrated delivery systems (IDS) to improve efficiency, quality, and access. The Health Care Safety Net Act of 2008 directed GAO to report on IDSs that serve underserved popu...
Medicare: Per Capita Method Can Be Used to Profile Physicians and Provide Feedback on Resource Use
GAO-09-802: Published: Sep 25, 2009. Publicly Released: Oct 26, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 directed the Secretary of Health and Human Services to develop a program to give physicians confidential feedback on the Medicare resources used to provide care to Medicare beneficiaries. GAO was asked to evaluate the per capita methodology for profiling physicians--a method which measures a patient's resource use over a fixed period...
Medicare Physician Services: Utilization Trends Indicate Sustained Beneficiary Access with High and Growing Levels of Service in Some Areas of the Nation
GAO-09-559: Published: Aug 28, 2009. Publicly Released: Sep 28, 2009.
Congress, policy analysts, and groups representing physicians have raised questions about beneficiary access to Medicare physician services. At the same time, high levels of spending for health care in some parts of the country, and rapid increases in spending for physician services, have been identified as factors that threaten the long-term fiscal sustainability of the Medicare program. GAO was...
Medicare Physician Payments: Fees Could Better Reflect Efficiencies Achieved When Services Are Provided Together
GAO-09-647: Published: Jul 31, 2009. Publicly Released: Aug 31, 2009.
Medicare's physician fees may not always reflect efficiencies that occur when a physician performs multiple services for the same patient on the same day, and some resources required for these services do not need to be duplicated. In response to a request from Congress, GAO examined (1) the Centers for Medicare & Medicaid Services' (CMS) efforts to set appropriate fees for services furnished toge...
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...
Hospital Emergency Departments: Bibliography (GAO-09-348SP, April 30, 2009), an E-supplement to GAO-09-347
GAO-09-348SP: Published: Apr 30, 2009. Publicly Released: Jun 1, 2009.
This is an e-supplement to GAO-09-347. This document presents a bibliography of a literature review conducted as part of our work on emergency department crowding (GAO-09-347). As part of our work to analyze and report on information made available since 2003 about (1) three indicators of emergency department crowding--ambulance diversion, wait times, and patient boarding, and (2) factors that con...
Hospital Emergency Departments: Crowding Continues to Occur, and Some Patients Wait Longer than Recommended Time Frames
GAO-09-347: Published: Apr 30, 2009. Publicly Released: Jun 1, 2009.
Hospital emergency departments are a major part of the nation's health care safety net. Of the estimated 119 million visits to U.S. emergency departments in 2006, over 40 percent were paid for by federally-supported programs. These programs--Medicare, Medicaid, and the State Children's Health Insurance Program--are administered by the Department of Health and Human Services (HHS). There have been...
TRICARE: Changes to Access Policies and Payment Rates for Services Provided by Civilian Obstetricians
GAO-07-941R: Published: Jul 31, 2007. Publicly Released: Jul 31, 2007.
About 111,000 women covered by the Department of Defense's (DOD) TRICARE program gave birth during 2006. During their pregnancies, about half of these women received obstetric care from physicians and other providers practicing at military hospitals and clinics called military treatment facilities (MTF), while half received their care from civilian physicians and other civilian providers. In recen...