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Medicare: Health Maintenance Organization Rate-Setting Issues

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Report Type Reports and Testimonies
Report Date Jan. 31, 1989
Report No. HRD-89-46
Subject
Summary:

Pursuant to a legislative requirement, GAO provided an overview of the data and methodology for computing Medicare monthly capitation payments to risk-contract health maintenance organizations (HMO).

GAO planned to meet its statutory mandate by discussing selected issues relating to the implementation of the current rate-setting methodology, problems with various aspects of rate-setting, and possible alternative approaches to Medicare HMO rate-setting.

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