In 2018, Medicare paid over $2 billion for anesthesia services such as those needed for surgery. In 2007, we reported that private insurance was paying about 3 times more for certain anesthesia services than Medicare was. Recent studies indicate that has increased to about 3.5 times more than what Medicare pays. Anesthesia providers can negotiate higher payments from private insurance for a number...

Prescription medications, if misused or overprescribed, can lead to dangerous drug interactions, abuse, overdose, or death. Prescription drug monitoring programs—state-operated electronic databases that track patient prescriptions for opioids and other medications—can help. Physicians said that access to these programs improved patient care and helped them prevent drug misuse and potentially d...

Genetic test results can help diagnose or confirm a condition. Genetic counseling can help explain the results and available treatment options. Some studies have raised concerns on whether there are enough genetic counselors and medical geneticists—genetic test providers—to meet the current and future demand for genetic services. About 4,700 genetic counselors and 1,240 medical geneticists are...

The Department of Veterans Affairs’ Graduate Medical Education program trains more than 45,000 medical and dental residents annually. It reimbursed affiliated medical schools and teaching hospitals about $765 million in 2019—covering residents’ salaries for their work at VA facilities. After detecting payment errors at one facility, VA added a new oversight process meant to complement an ex...

In 2018, almost 5 million Medicare beneficiaries used behavioral health services that the program covers. These include treatments for mental health and substance use disorders. Medicare wants to expand access to substance use disorder treatment, but some beneficiaries may not know these services are covered. Medicare’s coverage of these treatments is not explicitly outlined in the Medicare & Y...

When hospice patients die at home, they often leave behind commonly misused controlled substances, such as oxycodone. A 2018 law allows employees of qualified hospice programs to collect and destroy these drugs. This report describes selected home hospices’ disposal practices and the challenges they face. Hospice representatives identified best practices such as having a disposal witness and us...

Nearly 2 million Americans misused or were addicted to opioids in 2018. Medication-assisted treatment—which combines medications such as buprenorphine with behavioral therapy—can effectively treat opioid use disorders and overdoses. Medicaid is one of the largest sources of coverage for individuals undergoing medication-assisted treatment. The Department of Health and Human Services has worke...

People whose disabilities keep them from working can apply for Social Security Disability Insurance. People who claim these benefits may also be on prescription opioids for chronic pain. Opioids are addictive and can be misused. Social Security staff must deny claims if claimants who stopped using drugs or alcohol would be employable. Staff in 5 of 6 offices we visited were confused about when to...

Studies point to a physician shortage in the U.S., making it harder for people to get needed health care. Training more nurse practitioners and physician assistants could help people get care. Most federal funding to educate health care providers funds physician residencies through Medicare's graduate medical education program. Could that program be expanded to include nurse practitioners and phy...

Medicare pays for hospice care—pain and symptom management—for beneficiaries with terminal illness and a life expectancy of 6 months or less. The Centers for Medicare & Medicaid Services works with surveyors to inspect hospices to ensure compliance with federal health and safety standards. CMS also collects data on the quality of hospice care—like the number of hospice staff visits in the l...