United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1997-03-11 monographic deposited born digital 19 p. GA 1.13:T-HEHS-97-94 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-97-94 P0b002ee1803a306e f:he97094t DGPO 2010-08-12 2011-03-24 GAOREPORTS-T-HEHS-97-94 machine generated eng fdlp REPORT GAOREPORTS-T-HEHS-97-94 T-HEHS-97-94 Health care programs Health insurance cost control State-administered programs Medical economic analysis Hospitals Grants-in-aid Federal/state relations Managed health care Long-term care Payments Medicaid Program Testimony HEHS GAO discussed recent Medicaid spending trends and their potential implications for future outlays, focusing on: (1) key factors that explain the Medicaid 3.3-percent growth rate in fiscal year 1996; and (2) the administration's proposal to contain Medicaid cost growth through decreases in disproportionate share hospital (DSH) payments and per capita caps, and to increase state flexibility.<p/>GAO noted that: (1) GAO found no single pattern across all states that accounts for the recent dramatic decrease in the growth of Medicaid spending; (2) rather, a combination of factors, some affecting only certain states and others common to many states, explains the low 1996 growth rate; (3) leading factors include continued reductions in DSH payments in some states as a result of earlier federal restrictions on the amount of such payments and the leveling off of Medicaid enrollment in other states following planned expansions in prior years; (4) a number of states GAO contacted attributed the lower growth rate to a generally improved economy and state initiatives to limit expenditure growth through programmatic changes, such as managed care programs and long-term care alternatives; (5) while the magnitude of the effect of these programmatic changes is less clear, there is evidence that they helped to restrain program costs; (6) it is likely that the 3.3-percent growth rate is not indicative of the growth rate in the years ahead; (7) just as a number of factors converged to bring about the drop in the 1996 growth rate, so a variety of factors, such as a downturn in the economy, could result in increased growth rates in subsequent years; (8) the administration's proposal for Medicaid reform would further control spending by reducing DSH expenditures and imposing a per capita cap, while providing the states greater flexibility in program policy and administration for their managed care and long-term care programs; (9) these initiatives should produce cost savings; and (10) however, in controlling program spending, attention should be given to targeting federal funds appropriately and ensuring that added program flexibility is accompanied by effective federal monitoring and oversight. https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-97-94/html/GAOREPORTS-T-HEHS-97-94.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-97-94/pdf/GAOREPORTS-T-HEHS-97-94.pdf GAO/T-HEHS-97-94 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-97-94 Testimony GAO/T-HEHS-97-94; Medicaid: Recent Spending Experience and the Administration's Proposed Program Reform; Health care programs Health insurance cost control State-administered programs Medical economic analysis Hospitals Grants-in-aid Federal/state relations Managed health care Long-term care Payments Medicaid Program