Managed Care:
Oregon Program Appears Successful but Expansions Should Be Implemented Cautiously
T-HRD-91-48: Published: Sep 16, 1991. Publicly Released: Sep 16, 1991.
Additional Materials:
- Full Report:
Contact:
GAO discussed Oregon's proposal to expand its prepaid managed care activities as part of a demonstration that would restructure its entire Medicaid program, focusing on the existing managed care program that will serve as the foundation for the proposed demonstration project. GAO noted that: (1) since 1985, Oregon's Medicaid program has increased to an enrollment of about 65,000 and Oregon has contracted with 16 health service providers to provide Medicaid services; (2) all but one of those providers were capitated for physician and outpatient services only; (3) Medicaid clients received inpatient services on a fee-for-service basis; (4) Oregon designed its Medicaid demonstration project to expand Medicaid eligibility to all persons with incomes up to 100 percent of the federal poverty level while redefining the scope of health care services it will reimburse; (5) the project is aimed at providing services through a managed care system that is moving toward full service prepaid health plans capitated to provide inpatient and ambulatory care; (6) Oregon has avoided many problems that other states had experienced by instituting safeguards against inappropriate service delivery and quality and complying with federal quality assurance requirements; and (7) although Oregon anticipates full implementation of the project by 1992, it was unclear whether Oregon could implement the statewide system needed to serve the threefold increase in Medicaid managed care enrollments by 1992.
Apr 13, 2018
-
Defense Health Care:
TRICARE Select Implementation Plan Included Mandated Elements, but Access Standards Should Be ClarifiedGAO-18-358: Published: Apr 13, 2018. Publicly Released: Apr 13, 2018. -
Medicaid:
Opportunities for Improving Program Oversight [Reissued with Revisions Apr. 13, 2018]GAO-18-444T: Published: Apr 12, 2018. Publicly Released: Apr 12, 2018.
Apr 9, 2018
-
Federal Health Insurance Exchange:
CMS Needs to Ensure Complete Accurate Data on Terminations of Coverage for Nonpayment of PremiumsGAO-18-269: Published: Mar 9, 2018. Publicly Released: Apr 9, 2018.
Apr 5, 2018
-
Electronic Health Information:
CMS Oversight of Medicare Beneficiary Data Security Needs ImprovementGAO-18-210: Published: Mar 6, 2018. Publicly Released: Apr 5, 2018.
Mar 29, 2018
-
Defense Health Care:
TRICARE Surveys Indicate Nonenrolled Beneficiaries' Access to Care Has Generally ImprovedGAO-18-361: Published: Mar 29, 2018. Publicly Released: Mar 29, 2018. -
Physician Workforce:
HHS Needs Better Information to Comprehensively Evaluate Graduate Medical Education FundingGAO-18-240: Published: Mar 9, 2018. Publicly Released: Mar 29, 2018.
Mar 28, 2018
-
Food and Drug Administration:
Information on Mifeprex Labeling Changes and Ongoing Monitoring EffortsGAO-18-292: Published: Mar 28, 2018. Publicly Released: Mar 28, 2018.
Mar 23, 2018
-
Comparative Effectiveness Research:
Activities Funded by the Patient-Centered Outcomes Research Trust FundGAO-18-311: Published: Mar 23, 2018. Publicly Released: Mar 23, 2018.
Mar 19, 2018
-
New Trauma Care System:
DOD Should Fully Incorporate Leading Practices into Its Planning for Effective ImplementationGAO-18-300: Published: Mar 19, 2018. Publicly Released: Mar 19, 2018.
Mar 8, 2018
-
Health Care Funding:
Federal Obligations to and Expenditures by Selected Organizations Involved in Health-Related Activities, Fiscal Years 2013-2015GAO-18-204R: Published: Mar 6, 2018. Publicly Released: Mar 8, 2018.
Looking for more? Browse all our products here