United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2001-07-25 monographic deposited born digital 20 p. GA 1.13:GAO-01-1006T https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-1006T P0b002ee18038bb58 f:d011006t DGPO 2010-08-12 2011-03-24 GAOREPORTS-GAO-01-1006T machine generated eng fdlp REPORT GAOREPORTS-GAO-01-1006T GAO-01-1006T Health care programs Health insurance Health insurance cost control Internal controls Program management DOD TRICARE Program Hospital Insurance Trust Fund Medicare Choice Program Medicare Program National Medicare Education Program State Children's Health Insurance Program Testimony A01451 Management of Medicare has come under increasing scrutiny. The Health Care Financing Administration (HCFA) has had mixed success running the program. The agency has developed payment methods that have contained cost growth, and HCFA has paid fee-for-service claims quickly and at low administrative cost. However, HCFA has had difficulty ensuring that it paid claims appropriately. In addition, Medicare claims administration contractors have done a poor job of communicating with Medicare providers. HCFA has taken important steps to address some of these shortcomings, including strengthening payment safeguards, but several factors have hampered its efforts. Despite its growing responsibilities, HCFA suffers from staffing shortages. The agency also continues to rely on archaic computer systems. At the same time, HCFA has faltered in its attempts to adopt a results-based approach to agency management. Constraints on the agency's contracting authority have limited its use of full and open competition to select claims administration contractors and assign administrative tasks. Rising expectations among Medicare beneficiaries and providers are putting pressure on the Centers for Medicare and Medicaid Services to modernize and improve agency operations. Such improvements will require HCFA to begin a performance-based management approach that holds managers accountable for achieving program goals. Congressional attention also appears warranted if Medicare is to meet the challenges of the 21st century. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-1006T/html/GAOREPORTS-GAO-01-1006T.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-1006T/pdf/GAOREPORTS-GAO-01-1006T.pdf GAO-01-1006T https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-1006T Testimony GAO-01-1006T; Medicare: Successful Reform Requires Meeting Key Management Challenges; Health care programs Health insurance Health insurance cost control Internal controls Program management DOD TRICARE Program Hospital Insurance Trust Fund Medicare Choice Program Medicare Program National Medicare Education Program State Children's Health Insurance Program