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HRD-80-42 1 (1980-01-11)

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BY THE U,S, GENERAL ACCOUNTING OFFICE

Report To The Honorable Henry Bellmon

United States Senate                                          w






Savings Claimed For The Oklahoma

Hospital Utilization Review

System Were Overstated



The estimated savings claimed for the system
used to assess Medicare and Medicaid hospital
utilization  in  Oklahoma were overstated.

The estimated savings were based on incom-
plete and inaccurate Medicare and Medicaid
population and hospital claims data. In
addition, the estimates did not consider such
factors as the cost of operating the review
system, the fixed cost of maintaining an
empty hospital bed, and the cost of off-
setting charges for alternate forms of care,
such as skilled nursing care.

Although estimates based on corrected data
show  that hospital utilization  decreased
during the operation of the Oklahoma
Utilization Review System, other factors
may have contributed to the decline.


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      HRD-80-42
JANUARY 11, 1980

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