GAO Archives < RamaOnHealthcare

Q: GAO: More Native Americans report health coverage since ACA

About 78% of patients at federally operated Indian Health Service hospitals and health centers reported having health coverage in fiscal year 2018, up from 64% in FY 2013, according to a report released yesterday by the Government Accountability Office. The share of patients with Medicaid coverage rose by 12 percentage points over the period to 53%, while the share with Medicare or private coverage each rose by 2 percentage points to 11% and 20%, respectively, GAO said. Coverage rose twice as much in states that expanded Medicaid (14 points) than in states that did not (8 points). According to officials interviewed for the study, increased coverage and associated collections over the period helped IHS facilities to continue operating and offer more services to the American Indians and Alaska Natives they serve. The Affordable Care Act gave states the option to expand their Medicaid programs and created new coverage options beginning in 2014.

Q: GAO: Major changes for Medicaid waivers need more transparency

Despite some progress in transparency related to the process for Section 1115 Medicaid waivers, the Centers for Medicare & Medicaid Services’ “approach to ensuring transparency when states propose major changes to their demonstrations has significant gaps,” the Government Accountability Office said in a report released Friday. “The lack of policies for ensuring transparency when states make major changes to pending applications and limited transparency requirements applied for amendments – which are being used by some states to make major changes to their demonstrations – puts CMS’s goal of transparency at risk,” the report notes. “These gaps may leave the agency and the public without key information to fully understand the potential impact of the changes being proposed, including on beneficiaries and costs.” GAO recommended that CMS develop policies for ensuring transparency when states submit major changes to pending demonstration applications and propose amendments to existing demonstrations. The agency concurred with these recommendations.

Q: 3 largest health insurers held 80% of market in 2015-16, GAO says

The three largest private health insurers held 80 percent or more of the employer and individual market in 2015-16, according to a Government Accountability Office analysis . The GAO used enrollment data from 2015-16 that health insurers reported to CMS, and compared the data to 2011-14 enrollment figures. Some data sets also included other state and federal numbers. In at least 37 of 51 states, the three biggest payers held 80 percent of the market, which includes large and small group employers, as well as the individual market. GAO reported similar numbers for 2011-14. For the full report, click here .

Govt Agencies: GAO

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GAO: Feds have to improve oversight to stop drug companies from doling out duplicate 340B, Medicaid discounts

Rama Juturu2020-01-29T22:18:32-05:00

Fierce Health Payer January 28, 2020

GAO: Feds have to improve oversight to stop drug companies from doling out duplicate 340B, Medicaid discountsRama Juturu2020-01-29T22:18:32-05:00

Hospitals may be double dipping in drug discounts, GAO finds

Rama Juturu2020-01-28T18:33:32-05:00

Healthcare DIVE January 28, 2020

Hospitals may be double dipping in drug discounts, GAO findsRama Juturu2020-01-28T18:33:32-05:00

GAO: Food Assistance, SDOH Programs See Little Nutrition Oversight

Rama Juturu2020-01-04T19:41:50-05:00

Patient Engagement January 3, 2020

GAO: Food Assistance, SDOH Programs See Little Nutrition OversightRama Juturu2020-01-04T19:41:50-05:00

Artificial Intelligence in Health Care

Rama Juturu2020-01-22T23:57:49-05:00

GAO December, 2019

Artificial Intelligence in Health CareRama Juturu2020-01-22T23:57:49-05:00

GAO: More Native Americans report health coverage since ACA

Rama Juturu2019-10-02T19:30:59-04:00

AHA October 2, 2019

GAO: More Native Americans report health coverage since ACARama Juturu2019-10-02T19:30:59-04:00

GAO: CMS must do better job monitoring quality programs, funding

Rama Juturu2019-09-23T22:46:13-04:00

Fierce Healthcare September 23, 2019

GAO: CMS must do better job monitoring quality programs, fundingRama Juturu2019-09-23T22:46:13-04:00

CMS not appropriately tracking quality measure spending, objectives, GAO finds

Rama Juturu2019-09-23T18:16:58-04:00

Healthcare DIVE September 23, 2019

CMS not appropriately tracking quality measure spending, objectives, GAO findsRama Juturu2019-09-23T18:16:58-04:00

CMS Could More Effectively Ensure Its Quality Measurement Activities Promote Its Objectives

Rama Juturu2019-09-23T18:16:24-04:00

GAO September, 2019

CMS Could More Effectively Ensure Its Quality Measurement Activities Promote Its ObjectivesRama Juturu2019-09-23T18:16:24-04:00

Medicare quality measures need improvement, says government watchdog

Rama Juturu2019-09-20T18:57:07-04:00

Modern Healthcare September 20, 2019

Medicare quality measures need improvement, says government watchdogRama Juturu2019-09-20T18:57:07-04:00

How Care Management, Risk Stratification Cuts Medicaid Spending

Rama Juturu2019-09-17T17:10:01-04:00

Health Payer Intelligence September 17, 2019

How Care Management, Risk Stratification Cuts Medicaid SpendingRama Juturu2019-09-17T17:10:01-04:00

GAO: Staff shortages, social factors barriers to treating high-cost Medicaid beneficiaries

Rama Juturu2019-09-16T18:37:58-04:00

Fierce Health Payer September 16, 2019

GAO: Staff shortages, social factors barriers to treating high-cost Medicaid beneficiariesRama Juturu2019-09-16T18:37:58-04:00

Pharmacy benefit managers keep less than 1% percent of rebates for Medicare Part D drugs, GAO says

Rama Juturu2019-08-14T18:19:29-04:00

Healthcare Finance News August 14, 2019

Pharmacy benefit managers keep less than 1% percent of rebates for Medicare Part D drugs, GAO saysRama Juturu2019-08-14T18:19:29-04:00

GAO Calls HHS Health IT System High-Risk, Suggests EHR Modernization

Rama Juturu2019-06-12T18:15:49-04:00

EHR Intelligence June 12, 2019

GAO Calls HHS Health IT System High-Risk, Suggests EHR ModernizationRama Juturu2019-06-12T18:15:49-04:00

GAO: Major changes for Medicaid waivers need more transparency

Rama Juturu2019-05-20T20:45:24-04:00

AHA May 20, 2019

GAO: Major changes for Medicaid waivers need more transparencyRama Juturu2019-05-20T20:45:24-04:00

CMS conducting ‘comprehensive review’ of nursing home oversight processes following GAO report

Rama Juturu2019-04-16T13:37:32-04:00

Fierce Health Payer April 16, 2019

CMS conducting ‘comprehensive review’ of nursing home oversight processes following GAO reportRama Juturu2019-04-16T13:37:32-04:00

GAO: CMS Must Strengthen State-Level Oversight of Skilled Nursing Facilities

Rama Juturu2019-04-15T23:24:54-04:00

Skilled Nursing News April 15, 2019

GAO: CMS Must Strengthen State-Level Oversight of Skilled Nursing FacilitiesRama Juturu2019-04-15T23:24:54-04:00

GAO: HHS Fails to Implement High-Priority Health IT Recommendations

Rama Juturu2019-04-09T23:41:11-04:00

HIT Infrastructure April 9, 2019

GAO: HHS Fails to Implement High-Priority Health IT RecommendationsRama Juturu2019-04-09T23:41:11-04:00

DoD-VA EHR interoperability efforts lack single point of accountability

Rama Juturu2019-04-03T18:56:00-04:00

Health Data Management April 3, 2019

DoD-VA EHR interoperability efforts lack single point of accountabilityRama Juturu2019-04-03T18:56:00-04:00

The health insurer with largest employer market share in each state for 2016

Rama Juturu2019-03-26T23:12:02-04:00

Becker's Healthcare March 26, 2019

The health insurer with largest employer market share in each state for 2016Rama Juturu2019-03-26T23:12:02-04:00

3 largest health insurers held 80% of market in 2015-16, GAO says

Rama Juturu2019-03-22T23:15:36-04:00

Becker's Healthcare March 22, 2019

3 largest health insurers held 80% of market in 2015-16, GAO saysRama Juturu2019-03-22T23:15:36-04:00

PRIVATE HEALTH INSURANCE Enrollment Remains Concentrated among Few Issuers, including in Exchanges

Rama Juturu2019-03-21T23:20:52-04:00

GAO March 21, 2019

PRIVATE HEALTH INSURANCE Enrollment Remains Concentrated among Few Issuers, including in ExchangesRama Juturu2019-03-21T23:20:52-04:00

Insurer costs vary widely in ACA exchange: GAO report

Rama Juturu2019-01-30T23:19:51-05:00

Healthcare DIVE January 30, 2019

Insurer costs vary widely in ACA exchange: GAO reportRama Juturu2019-01-30T23:19:51-05:00

Health Insurance Exchanges Claims Costs and Federal and State Policies Drove Issuer Participation, Premiums, and Plan Design

Rama Juturu2019-01-30T23:19:19-05:00

GAO January, 2019

Health Insurance Exchanges Claims Costs and Federal and State Policies Drove Issuer Participation, Premiums, and Plan DesignRama Juturu2019-01-30T23:19:19-05:00

Providers may leave bundled payment models due to financial risk, GAO says

Rama Juturu2019-01-24T23:00:39-05:00

Becker's Healthcare January 24, 2019

Providers may leave bundled payment models due to financial risk, GAO saysRama Juturu2019-01-24T23:00:39-05:00