Medicare: New Claims Processing System Benefits and Acquisition Risks
(Letter Report, 01/25/94, GAO/HEHS/AIMD-94-79).
A new system for processing Medicare claims offers considerable
opportunities to improve Medicare operations and safeguard program
dollars. As such, the Medicare Transaction System--a new automated
system for processing claims--could strengthen the Health Care Financing
Administration's (HCFA) ability to manage contractor performance.
Although HCFA projects that the new system should yield administrative
cost savings, the exact amount of these is uncertain. HCFA's planning
and acquisition strategy for the system is fraught with risks that could
prevent the new system from achieving its intended benefits and could
produce cost increases and schedule delays. GAO supports HCFA's
planning and acquisition strategy changes to address these concerns.
Because of the size, complexity, and importance of the system to the
Medicare program, however, oversight by top management and Congress is
essential.
--------------------------- Indexing Terms -----------------------------
REPORTNUM: HEHS/AIMD-94-79
TITLE: Medicare: New Claims Processing System Benefits and
Acquisition Risks
DATE: 01/25/94
SUBJECT: Concurrency
Medicare programs
Computerized information systems
Strategic information systems planning
Health insurance cost control
Administrative costs
Requirements definition
Risk management
Claims processing
IDENTIFIER: HCFA Medicare Transaction System
National Health Care Reform Initiative
Clinton Health Care Plan
Health Security Act
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