Purchasing Health Care Services in a Competitive Environment: Hearing Before the Committee on Finance, United States Senate, One Hundred Eighth Congress, First Session, April 3, 2003U.S. Government Printing Office, 2003 - 157 pages |
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10S+ BCBS Standard 11 BLUE CROSS 1R ALLIANCE HEALTH 31H GEHA BENEFIT 32 NALC HEALTH 36S POSTMASTERS BENEFIT 38 NATIONAL RURAL 44 SAMBA HEALTH 45H MAIL HANDLERS 47 AMERICAN POSTAL AETNA US HEALTHCARE ALLIANCE HEALTH BENEFIT AMERICAN FOREIGN SERVICE AMERICAN POSTAL WORKERS April 11 ASSOCIATION BENEFIT PLAN BLUE SHIELD SERVICE CODE YQ/YK/YA competitive CONGRESS THE LIBRARY costs CROSS AND BLUE Family Self Family fee-for-service fee-for-service plans FEHBP FOREIGN SERVICE PROTECTIVE GEHA BENEFIT PLAN GROUP HEALTH COOPERATIVE HANDLERS BENEFIT PLAN HBDF PLAN TOTALS HEALTH BENEFIT PLAN KAISER FOUNDATION HP LETTER CARRIERS ASSOCIATION MAIL HANDLERS BENEFIT NALC HEALTH BENEFIT NATIONAL RURAL LETTER PBMs percent Plan Total Contracts PLAN TOTALS 2002 PLAN WAS CODE POSTAL WORKERS UNION POSTMASTERS BENEFIT PLAN RURAL LETTER CARRIERS SAMBA HEALTH BENEFIT Senator BAUCUS Senator BREAUX SERVICE PROTECTIVE ASSOCIATION SHIELD SERVICE BASIC Standard plus plans Total Self Family TRICARE UNION HEALTH PLAN WORKERS UNION HEALTH
Popular passages
Page 149 - PBMs, and whether they are holding down drug costs, or responsible, in part, for their significant increases. The experience of the government's own FEHBP should be instructive to Members of Congress as they consider the true effectiveness and competitiveness of this approach to providing a prescription drug benefit for seniors. Our analysis indicates that escalating prescription drug spending in the FEHBP program — which is administered by...
Page 129 - ... for payment. Nonavailability statements are not required for emergency care or outpatient care regardless of whether the beneficiaries reside within 40 miles of uniformed services hospitals. SCOPE OF REVIEW We made our review at the Offices of the Assistant Secretary of Defense (Health Affairs) and the Surgeons General of the Army, Navy, and Air Force and the headquarters of the Public Health Service in Washington, DC To assess the effect of the 40-mile rule, we also reviewed records and held...
Page 135 - Alcohol and Other Drug Treatment for Parents and Welfare Recipients: Outcomes, Costs, and Benefits.
Page 135 - Recipients Many women involved in the criminal justice system have alcohol and drug problems and will need treatment and other services to make the transition to employment. However, few studies have...
Page 149 - Mr. Chairman and Members of the Committee. The National Association of Chain Drug Stores (NACDS...
Page 5 - Unlike the 1980's when we were flooded with applications in the current market, we average about six new plans a year. Rates are negotiated with the national plans based primarily on their claims experience. About 93 percent of premium, or 93 cents out of every dollar, reflects benefit costs. The remaining 7 percent covers the plans
Page 48 - While all participating plans offer a core set of benefits broadly outlined in statute, benefits vary among plans because there is no standard benefits package. Even where coverage is nearly identical, cost-sharing provisions may differ significantly among plans.
Page 152 - OOD and the military eligibles and retirees. Thus, there are two major Federal government health care programs using different approaches - with very different outcomes - to provide pharmacy benefits to two important populations. NACDS and community pharmacy support approaches to delivering a Medicare pharmacy benefit that take the perverse rebate incentives out of the system, since it results in nothing more than limiting seniors' access to needed medications and the pharmacy of their choice.
Page 49 - ... Underserved Areas" that ensures that Members have access to health care providers. Our fee-for-service plans must pay for covered services provided by any licensed provider practicing within the scope of his or her license, even if that provider is not considered a covered plan provider. Conclusion The FEHB Program uses a hybrid approach that shares practices with both public sector and private employer health insurance programs. While we believe the program has been very successful over its...
Page 48 - The Office of Personnel Management (OPM) has developed widely-recognized expertise in the complexities of arranging health care coverage with more than one hundred private sector health plans with a covered population of about eight and a half million people including 2.2 million employees, 1.9 million retirees, and members of their families.