Medicare: Further Changes Needed to Reduce Program and Beneficiary Costs
HRD-91-67
Published: May 15, 1991. Publicly Released: Jun 14, 1991.
Skip to Highlights
Highlights
Pursuant to a congressional request, GAO provided information on Medicare's efforts to reduce its program and beneficiary costs.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| Congress may wish to consider directing HCFA to test and assess alternative ways to market HMO that serve Medicare beneficiaries. Specifically, Congress could direct that HCFA conduct demonstrations to test-market HMO through independent third-party organizations operating under HCFA direction. | Congress has not yet taken action. Reforms for managed care initiatives are being considered in the context of broad-based health care reform. | |
| Congress should consider broadening HCFA sanction authority, for example, by authorizing civil monetary penalties when HMO do not comply with peer review organization review requirements. | Congress has not yet taken action. Reforms for managed care initiatives are being considered in the context of broad-based health care reform. | |
| Increasing funding for payment safeguard activities, and thereby preventing inappropriate program payments, could help lessen the need for the difficult across-the-board cuts to all providers that Congress is faced with annually. Consequently, Congress should consider appropriating additional funds for contractor safeguard activities. | Recently passed legislation (Health Insurance Portability and Accountability Act of 1996) provides new funding mechanisms for program safeguard activities. | |
| Because of the strong potential for a net reduction in federal spending, Congress should consider establishing a similar means of facilitating increased expenditures to fund Medicare administrative costs. | Several bills have been introduced to implement this recommendation, but none have been enacted. Given rigorous budgetary constraints and competing demands, Congress is not likely to enact this recommendation. |
Full Report
Public Inquiries
Topics
Health care cost controlHealth care servicesHealth maintenance organizationsHealth services administrationMedical services ratesMedicareOverpaymentsOversight committeesPhysiciansProgram evaluation