Federal Prisons: Responses to Questions Related to Containing Health Care Costs for an Increasing Inmate Population Page: 2 of 8
The following text was automatically extracted from the image on this page using optical character recognition software:
anticipated if some additional charge were levied. However, we were not provided with an
estimate of the magnitude of the anticipated reduction.
Question 2. Does it appear that states have benefited from a copay requirement?
As noted in response to the previous question, CBO has reported that after adopting
copayment requirements, 36 state or local jurisdictions experienced reductions in the number
of sick call visits. These reductions ranged from a low of 16 percent to a high of 50 percent.
Question 3. It appears that personnel salaries are the primary category for health
care costs. Have recent BOP initiatives, such as restructuring staff to depend less on
highly paid physicians for routine duties, helped reduce staff costs in recent years?
One BOP official told us that, as a result of our 1994 report,2 BOP began examining the
utilization of its health care staff to allow for more efficient operations. One result the BOP
official cited was a restructuring initiative that focused on using qualified, lower-salaried
medical personnel instead of more highly paid physicians and physicians' assistants for
certain routine duties. BOP attributed annual savings of about $5.5 million to this initiative.
We also testified that BOP medical personnel salaries-on a macro level-have decreased
steadily from a peak of $1,399 per inmate in fiscal year 1996 to $1,225 in fiscal year 1999. We
testified that Public Health Service (PHS) associated costs, largely composed of PHS salaries,
have dropped from $378 per inmate in fiscal year 1997 to $367 in fiscal year 1999. A BOP
Health Services Division official was quite confident that the downward slope in per inmate
medical personnel salaries and PHS associated costs was due to the staff restructuring
initiative and other related cost-cutting initiatives. However, BOP officials were concerned
that the savings from these economy and efficiency measures will eventually bottom out.
BOP officials said they expect overall medical costs to continue to rise in future years for
* Projections of the number of inmates incarcerated in federal facilities show continued
* Felony inmates transferred to BOP from the District of Columbia Department of Corrections
generally have disproportionately more medical needs than other BOP inmates.
* BOP is receiving increasing numbers of long-term, nonreturnable detainees from the
Immigration and Naturalization Service (INS).
* BOP's expenditures for pharmaceuticals likely will rise due to the increasing prevalence of
illnesses such as HIV and hepatitis.
Question 4. You noted during your oral testimony that many inmates are staying in
medical referral centers for long periods due to serious medical conditions. Do you
think it may be more cost effective for BOP to have an intermediate care medical
facility for inmates needing long-term care?
2 Bureau of Prisons Health Care: Inmates' Access to Health Care Is Limited by Lack of Clinical Staff (GAO/HEHS-94-36, Feb. 10,
GGD-00-160R Questions About Inmate Health Care Costs
Here’s what’s next.
This text can be searched. Note: Results may vary based on the legibility of text within the document.
Tools / Downloads
Get a copy of this page or view the extracted text.
Citing and Sharing
Basic information for referencing this web page. We also provide extended guidance on usage rights, references, copying or embedding.
Reference the current page of this Text.
United States. General Accounting Office. Federal Prisons: Responses to Questions Related to Containing Health Care Costs for an Increasing Inmate Population, text, June 14, 2000; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc298486/m1/2/: accessed January 17, 2019), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.