Literature GAO reviewed indicated that private insurance payments for anesthesia services on average were more than 3-1/2 times those of Medicare payments. This payment difference increased from what GAO reported in 2007—average private insurance payments for certain anesthesia services in 2004 were about 3 times those of Medicare. While Medicare rates for anesthesia services are set by the Cen

Physicians GAO interviewed generally found prescription drug monitoring programs (PDMPs) to be useful in preventing drug misuse and potentially dangerous drug prescribing. PDMPs are state-operated electronic databases that track prescriptions patients receive for opioids or other medications that are at risk of being misused. Most of the 31 physicians GAO interviewed said PDMP information helped

The Department of Veterans Affairs' (VA) Veterans Health Administration (VHA) provides training to more than 45,000 medical and dental residents annually through its Graduate Medical Education (GME) program. VHA has established policy for its GME program that details many roles and responsibilities for overseeing VA medical facilities' reimbursements to affiliated academic institutions for reside

GAO's analysis of Medicare claims data shows that in 2018 almost 5 million beneficiaries used behavioral health services—services for mental and substance use disorders. This represented about 14 percent of the more than 36 million fee-for-service (traditional) Medicare beneficiaries and reflects about $3.3 billion in spending. Additionally, about 96 percent of all behavioral health services ac

Hospice care helps patients who are terminally ill maintain their quality of life. Most patients get hospice care at home, which typically includes use of controlled substances, including opioids such as oxycodone, to provide pain relief. When hospice patients die at home, they often leave behind unused controlled substances, which can be diverted and misused by anyone with access to them. The Su

The federal government funds many education programs for health care providers, but the vast majority of this funding—more than $10.3 billion in 2015—supports physician residency training through the Department of Health and Human Services's (HHS) Medicare graduate medical education (GME) program. This program does not fund graduate training for nurse practitioners (NP) and physician assistan

The National Defense Authorization Act for Fiscal Year 2017 (NDAA 2017) directed the Secretary of Defense to establish and implement a process to oversee military graduate medical education (GME). The goal was to ensure GME programs fully supported operational medical force readiness, and the NDAA 2017 included several requirements for the process. In July 2018, the Department of Defense (DOD) pr

GAO found that Veterans Health Administration (VHA) facilities responded in various ways to adverse-action information from the National Practitioner Data Bank (NPDB) for the 57 providers reviewed, and in some cases overlooked or were not aware of adverse action. (1) In some cases, providers had administrative or other nondisqualifying adverse actions reported in the NPDB, but VHA facilities dete

Advance care planning documents-including advance directives and physician orders for life sustaining treatment (POLST)-allow individuals to express their wishes for end-of-life care. Advance directives, which include living wills and health care power of attorney, provide direction regarding care when an individual becomes incapacitated. POLST documents are appropriate for seriously ill individu

Indian Health Service (IHS) data show sizeable vacancy rates for clinical care providers in the eight IHS geographic areas where the agency provides substantial direct care to American Indian/Alaska Native (AI/AN) people. The overall vacancy rate for providers--physicians, nurses, nurse practitioners, certified registered nurse anesthetists, certified nurse midwives, physician assistants, dentist