Reported Problems in Access to Posthospital Care for Medicare Beneficiaries
T-PEMD-87-2: Published: Feb 26, 1987. Publicly Released: Feb 26, 1987.
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GAO testified on its study of Medicare beneficiaries' access to post-hospital care, primarily in skilled nursing facilities (SNF). Medicare post-hospital benefits cover short-term skilled nursing and strictly limit the types and amounts of services. The most frequent problems preventing SNF placement were the Medicare program rules and regulations, the availability of beds, and the need for complex skilled services. Prior to the Medicare prospective payment system (PPS), hospitals could have been providing too much unnecessary and inappropriate care. In shifting to PPS, Medicare removed the financial incentive to provide more health care services than needed and, therefore, the extent to which hospitals discharge patients while they still need acute hospital care has become a primary concern. Under PPS, hospital stays have changed from being generally profitable to relatively unprofitable, which pressures hospitals to discharge patients. There are numerous reports of cases in which hospitals discharged people in unstable medical condition or without adequate provision for post-hospital care. Development of a uniform needs assessment instrument has begun that would evaluate functional capacity and establish the need for post-hospital care services and would also require hospitals to have a discharge planning program as a condition for their participation in the Medicare program. However, important questions remain about identifying and correcting problems related to access, quality, and costs of post-hospital care.
Jan 21, 2021
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Rural Hospital Closures:
Affected Residents Had Reduced Access to Health Care ServicesGAO-21-93: Published: Dec 22, 2020. Publicly Released: Jan 21, 2021. -
Health Care Funding:
Federal Obligations to and Funds Received by Certain Organizations Involved in Health-Related Services, 2016 through 2018GAO-21-188R: Published: Dec 21, 2020. Publicly Released: Jan 21, 2021.
Jan 14, 2021
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Medicaid:
Data Completeness and Accuracy Have Improved, Though Not All Standards Have Been MetGAO-21-196: Published: Jan 14, 2021. Publicly Released: Jan 14, 2021.
Jan 4, 2021
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Medicare Severe Wound Care:
Spending Declines May Reflect Site of Care Changes; Limited Information Is Available on QualityGAO-21-92: Published: Jan 4, 2021. Publicly Released: Jan 4, 2021.
Dec 22, 2020
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Defense Health Care:
Efforts to Ensure Beneficiaries Access Specialty Care and Receive Timely and Effective CareGAO-21-143: Published: Dec 22, 2020. Publicly Released: Dec 22, 2020.
Dec 16, 2020
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Medicaid Long-Term Services and Supports:
Access and Quality Problems in Managed Care Demand Improved OversightGAO-21-49: Published: Nov 16, 2020. Publicly Released: Dec 16, 2020.
Dec 14, 2020
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Drug Pricing Program:
HHS Uses Multiple Mechanisms to Help Ensure Compliance with 340B RequirementsGAO-21-107: Published: Dec 14, 2020. Publicly Released: Dec 14, 2020. -
Substance Use Disorder:
Reliable Data Needed for Substance Abuse Prevention and Treatment Block Grant ProgramGAO-21-58: Published: Dec 14, 2020. Publicly Released: Dec 14, 2020.
Dec 10, 2020
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Indian Health Service:
Actions Needed to Improve Oversight of Provider Misconduct and Substandard PerformanceGAO-21-97: Published: Dec 10, 2020. Publicly Released: Dec 10, 2020. -
Clinical Labs:
Studies Suggest Biopsy Specimen Misidentification and Contamination Errors Are InfrequentGAO-21-59: Published: Nov 10, 2020. Publicly Released: Dec 10, 2020.
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