“GAO was asked to compare IHS program characteristics, including spending levels, to those of other federal health care programs. In this report, GAO presents information on the spending levels and program characteristics for IHS, VHA, Medicare, and Medicaid from 2013 through 2017…”
“There are several key differences in terms of design and structure, funding, and populations served, between Indian Health Service (IHS) and three other federal health programs–the Veterans Health Administration (VHA), Medicaid, and Medicare. For example, Medicare and Medicaid are entitlement programs and have no annual spending caps, while IHS and VHA have funding that is largely determined through the annual appropriations process and have specific spending limits.”
“Other important differences include:
Program Design and Structure: IHS and VHA are direct health care providers that operate health care facilities and employ health care professionals. In contrast, Medicare and Medicaid are entitlement programs that act as public insurers for their beneficiaries and pay health care providers for covered health care services.
Funding Mechanism: IHS and VHA must deliver services within their available appropriations. Thus, any increases in the number of people served could result in reductions in per capita spending, absent increased funding. Medicare and Medicaid, as entitlement programs, have no spending caps. Instead, spending for these programs is controlled by Congress through a modification of benefits or changes to the way providers are paid…” Read the full report here.
Source: Indian Health Service: Spending Levels and Characteristics of IHS and Three Other Federal Health Care Programs – December 10, 2018. GAO.
