Health care cost control (11 - 20 of 47 items)
Medicare: Competitive Bidding for Medical Equipment and Supplies Could Reduce Program Payments, but Adequate Oversight Is Critical
GAO-08-767T: Published: May 6, 2008. Publicly Released: May 6, 2008.
For more than a decade, GAO has reported that Medicare has paid higher than market rates for medical equipment and supplies provided to beneficiaries under Medicare Part B. Since 1989, Medicare has used fee schedules primarily based on historical charges to set payment amounts. But this approach lacks flexibility to keep pace with market changes and increases costs to the federal government and Me...
Health Savings Accounts: Participation Increased and Was More Common among Individuals with Higher Incomes
GAO-08-474R: Published: Apr 1, 2008. Publicly Released: Apr 30, 2008.
With health care spending increasing in the United States, you enacted legislation effective in 2004 establishing tax advantaged health savings accounts (HSA) to be coupled with high-deductible health insurance plans. HSA-eligible high-deductible health plans typically have lower premiums than traditional health plans and HSAs allow account holders to accumulate tax-free savings to pay for medical...
DOD Pharmacy Program: Continued Efforts Needed to Reduce Growth in Spending at Retail Pharmacies
GAO-08-327: Published: Apr 4, 2008. Publicly Released: Apr 4, 2008.
Estimated to reach $15 billion by 2015, the Department of Defense's (DOD) prescription drug spending has been a growing concern for the federal government. The John Warner National Defense Authorization Act (NDAA) for Fiscal Year 2007 required GAO to examine DOD's pharmacy benefits program. Specifically, as discussed with the committees of jurisdiction, GAO examined DOD's prescription drug spendin...
VA Health Care: Additional Efforts to Better Assess Joint Ventures Needed
GAO-08-399: Published: Mar 28, 2008. Publicly Released: Mar 28, 2008.
The Department of Veterans Affairs (VA) and the Department of Defense (DOD) have a long history of partnering to achieve more cost-effective use of health care resources. Their partnerships have evolved to include joint ventures--joint efforts to construct or share medical facilities. VA has maintained eight joint ventures with DOD across the country. VA has also developed partnerships, or affilia...
Medicaid Demonstration Waivers: Recent HHS Approvals Continue to Raise Cost and Oversight Concerns
GAO-08-87: Published: Jan 31, 2008. Publicly Released: Mar 3, 2008.
Medicaid, a joint federal and state program, finances health care for 60 million low-income people. Section 1115 of the Social Security Act authorizes the Secretary of Health and Human Services to waive certain federal Medicaid requirements and allow demonstration projects that are likely to promote Medicaid objectives. Under federal policy, states must show that federal spending for proposed demo...
Medicare Advantage: Higher Spending Relative to Medicare Fee-for-Service May Not Ensure Lower Out-of-Pocket Costs for Beneficiaries
GAO-08-522T: Published: Feb 28, 2008. Publicly Released: Feb 28, 2008.
Although private health plans were originally envisioned in the 1980s as a potential source of Medicare savings, such plans have generally increased program spending. In 2006, Medicare paid $59 billion to Medicare Advantage (MA) plans--an estimated $7.1 billion more than Medicare would have spent if MA beneficiaries had received care in Medicare fee-for-service (FFS). MA plans receive a per member...
Medicare Advantage: Increased Spending Relative to Medicare Fee-for-Service May Not Always Reduce Beneficiary Out-of-Pocket Costs
GAO-08-359: Published: Feb 22, 2008. Publicly Released: Feb 28, 2008.
In 2006, the federal government spent about $59 billion on Medicare Advantage (MA) plans, an alternative to the original Medicare fee-for-service (FFS) program. Although health plans were originally envisioned in the 1980s as a potential source of Medicare savings, such plans have generally increased program spending. Payments to MA plans have been estimated to be 12 percent greater than what Medi...
Medicare Physician Payment: Care Coordination Programs Used in Demonstration Show Promise, but Wider Use of Payment Approach May Be Limited
GAO-08-65: Published: Feb 15, 2008. Publicly Released: Feb 15, 2008.
Congress mandated in 2000 that the Centers for Medicare & Medicaid Services (CMS) conduct the Physician Group Practice (PGP) Demonstration to test a hybrid payment methodology for physician groups that combines Medicare fee-for-service payments with new incentive payments. The 10 participants, with 200 or more physicians each, may earn annual bonus incentive payments by achieving cost savings and...
Medicaid Long-Term Care: Few Transferred Assets before Applying for Nursing Home Coverage; Impact of Deficit Reduction Act on Eligibility Is Uncertain
GAO-07-280: Published: Mar 26, 2007. Publicly Released: Apr 25, 2007.
The Medicaid program paid for nearly one-half of the nation's total long-term care expenditures in 2004. To be eligible for Medicaid long-term care, individuals may transfer assets (income and resources) to others to ensure that their assets fall below certain limits. Individuals who make transfers for less than fair market value (FMV) can be subject to a penalty that may delay Medicaid coverage....
Medicare: Sponsors' Management of the Prescription Drug Discount Card and Transitional Assistance Benefit
GAO-06-299R: Published: Jan 13, 2006. Publicly Released: Feb 21, 2006.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) added a prescription drug benefit to the Medicare program, which became effective January 1, 2006. To assist Medicare beneficiaries with their prescription drug costs until the new benefit became available, the MMA also required the establishment of a temporary program, the Medicare Prescription Drug Discount Card and...