GAO’s reports and testimonies give Congress, federal agencies, and the public timely, fact-based, non-partisan information that can improve government operations and save taxpayers billions of dollars.
To save money and improve health care quality, Medicare has been trying alternative payment models for reimbursing providers. Some models require providers to use electronic health records or to accept financial risk.
Under Medicare’s Merit-based Incentive Payment System, doctors and other providers may receive increases or decreases to their Medicare payments based on factors like the cost and quality of care they provide.
Behavioral health conditions such as depression and opioid use disorder affected an estimated 61 million U.S. adults in 2019. Research has shown that low-income individuals, such as those enrolled in Medicaid, are at greater risk of developing such conditions.
Medicare Part B's Physician Fee Schedule covers payments for services such as office visits. Some have noted that payment rates may not fully account for the unique local characteristics of Alaska, Hawaii, and the U.S. territories.
In 2020, Medicare spent about $9 billion on wheelchairs, oxygen, and other durable medical equipment.
To save money and reduce fraud, Medicare implemented a competitive bidding program for suppliers to provide certain items in different geographic areas.
Since 2014, millions of Americans have purchased health insurance through exchanges—or marketplaces—established under the Affordable Care Act.
Our investigators posed as people with pre-existing conditions seeking health insurance to test if sales representatives listed on healthcare.
Medicare spent nearly $28 billion in 2019 on short-term care for 1.5 million beneficiaries in skilled nursing facilities after hospital stays.
Research indicates low nurse staffing can lead to potentially preventable re-hospitalizations.
Medicare Advantage contracts with private insurers to provide health care coverage to beneficiaries. It pays plans a fixed monthly amount per beneficiary, unlike Medicare fee-for-service, which pays provider claims for services.