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 1999-06-09 monographic deposited born digital 13 p. GA 1.13:T-HEHS-99-137 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-99-137 P0b002ee1803a0eac f:he99137t DGPO 2010-08-12 2011-03-23 GAOREPORTS-T-HEHS-99-137 machine generated eng fdlp REPORT GAOREPORTS-T-HEHS-99-137 T-HEHS-99-137 Health care programs Health insurance cost control Managed health care Medical services rates Overpayments Health care costs Medicare Choice Program Medigap Medicare Program Testimony HEHS Pursuant to a congressional request, GAO discussed on the impact of payment reforms in the Balanced Budget Act of 1997 (BBA) on the Medicare Choice program.<p/>GAO noted that: (1) the net effect of BBA payment revisions has been to reduce but not fully eliminate excess payments to health plans; (2) some of the provisions, such as the reduced annual updates, have already been implemented, while others, such as the health-based risk adjustment system, will be phased in over time; (3) despite industry alarm over the increase in plan withdrawals in 1999, GAO's work suggests that sweeping amendments to the BBA are not yet warranted for several reasons; (4) the net effect of BBA reforms on plans has been modest to date; (5) cuts in rate increases have held down per capita payment growth by only a little more than 1 percent; (6) data submitted by plans themselves indicate that at least some plans can provide the traditional Medicare package of benefits, offer some additional benefits, and make a profit even if they are paid less than they are today; (7) according to their own data, plans serving the Los Angeles area can provide the traditional Medicare package of benefits for about 79 percent of what they are currently paid; (8) the withdrawals GAO observed this year were not a reaction to BBA rate reductions alone; (9) market forces appear to have played a larger role; (10) because of cuts in rate increases and expected improvements in risk adjustment, the BBA's health plan payment reforms will reduce aggregate excess payments; (11) as a consequence, some Medicare Choice plans may reduce supplemental benefits and rethink their participation in the Medicare program; and (12) the continuing challenge for Congress is to strike the appropriate balance between containing Medicare spending and fostering growth in Medicare Choice. https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-99-137/html/GAOREPORTS-T-HEHS-99-137.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-99-137/pdf/GAOREPORTS-T-HEHS-99-137.pdf GAO/T-HEHS-99-137 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-99-137 Testimony GAO/T-HEHS-99-137; Medicare+Choice: Impact of 1997 Balanced Budget Act; Health care programs Health insurance cost control Managed health care Medical services rates Overpayments Health care costs Medicare Choice Program Medigap Medicare Program