Several health care and legal factors may make it difficult for consumers to obtain price information for the health care services they receive, particularly estimates of what their complete costs will be. The health care factors include the difficulty of predicting health care services in advance, billing from multiple providers, and the variety of insurance benefit structures. For example, when

Our review found articles that measured the extent of concentration in private health insurance markets or focused on the relationship between competition in these markets and other variables, though the findings of these studies should be interpreted with caution. Several articles identified through our review examined the extent of concentration in private health insurance markets, though this

GAO's review of states' implementation of Medicaid's new payment system--the BIPA PPS and alternative methodologies--for FQHCs and RHCs identified certain issues regarding the appropriateness of some states' methodologies. Most states used the BIPA PPS and about half of states used an alternative methodology--generally cost-based reimbursement or a PPS with features slightly different from those

GAO noted that: (1) GAO's original evaluation design called for conducting surveys of MSA enrollees and employers to obtain a consumer perspective on MSAs, and surveys of insurers and financial institutions to obtain the perspective of suppliers; (2) GAO competitively awarded four contracts to companies with experience in health economics, health insurance, and actuarial science, and selected Wes

GAO noted that: (1) views on benefits and limitations of disposable infusion pumps vary across providers and by type of IV drug; (2) for example, most clinicians and pharmacists GAO interviewed said that disposable infusion pumps can be used to administer IV antibiotics and IV antivirals; (3) they also agreed that disposable pumps were not appropriate for IV pain medications; (4) however, there w

GAO noted that: (1) the overall insurance picture of the near elderly is no worse than that of other segments of the under-65 population and is better than that of some younger age groups; (2) the current insurance status of the near elderly is largely due to: (a) the fact that many current retirees still have access to employer-based health benefits; (b) the willingness of near-elderly Americans

GAO noted that: (1) though the near elderly access health insurance differently than other segments of the under-65 population, their overall insurance picture is no worse and is better than that of some younger age groups; (2) since fewer employers are offering health coverage as a benefit to future retirees, the proportion of near elderly with access to affordable health insurance could decline

GAO noted that: (1) although HIPAA gives people losing coverage a guarantee of access to coverage in the individual market, consumers attempting to exercise this right have been hindered in some states by carrier practices and pricing and by their own misunderstanding of this complex law; (2) in the 13 states using the federal fallback approach to guaranteed access, some carriers initially discou

GAO plans to examine: (1) actions to improve the management and financial integrity of the Medicare and Medicaid programs; (2) new strategies for paying for Medicare and Medicaid services that promote cost containment while preserving quality and access; (3) how financing arrangements affect Medicare and Medicaid beneficiaries access to quality care; (4) the interactions between the Medicare and

GAO noted that: (1) Medicare payment rates to HMOs are often considered to be the primary influence on Medicare HMO enrollment; (2) however, GAO's analysis suggest that several other factors also play a key, and sometimes, dominant role; (3) these factors include HMO presence, number of Medicare beneficiaries, and employers' policies toward retiree health benefits, and their relative importance v