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portada Indian Health Service: capping payment rates for nonhospital services could save millions of dollars for contract health services: report to
Type
Physical Book
Author
Publisher
Language
English
Pages
54
Format
Paperback
Dimensions
27.9 x 21.6 x 0.3 cm
Weight
0.15 kg.
ISBN13
9781974195152
Categories

Indian Health Service: capping payment rates for nonhospital services could save millions of dollars for contract health services: report to

U. S. Government Accountability Office (Author) · Createspace · Paperback

Indian Health Service: capping payment rates for nonhospital services could save millions of dollars for contract health services: report to - Office, U. S. Government Accountability

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Synopsis "Indian Health Service: capping payment rates for nonhospital services could save millions of dollars for contract health services: report to"

" IHS provides health care to American Indians and Alaska Natives. When care at an IHS-funded facility is unavailable, IHS's CHS program pays for care from external providers. Hospitals are required to accept Medicare rates from federal and tribal CHS programs, while physicians and other nonhospital providers are paid at either billed charges or negotiated, reduced rates. The Patient Protection and Affordable Care Act requires GAO to compare CHS program payment rates with those of other public and private payers. GAO examined (1) how payments to physicians by IHS's federal CHS programs compare with what Medicare and private health insurers would have paid for the same services, (2) physicians' perspectives about how a cap on payment rates could affect them, (3) hospitals' perspectives about how the MLR requirement affected them, and (4) IHS and tribal officials' perspectives about the MLR requirement and a potential cap on nonhospital services. GAO compared 2010 physician claims data for federal CHS programs with the Medicare Physician Fee Schedule and claims from private insurers. GAO also spoke to a nongeneralizable sample of 10 physicians and 9 hospitals that interacted frequently with IHS and spoke to IHS and tribal officials where these providers practiced. "

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