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Medicare Value-Based Payment Models: Participation Challenges and Available Assistance for Small and Rural Practices
GAO-17-55: Published: Dec 9, 2016. Publicly Released: Dec 9, 2016.
Based on a review of literature and interviews with 38 stakeholders, GAO identified challenges faced by small and rural physician practices when participating in Medicare's new payment models. These models, known as value-based payment models, are intended to reward health care providers for resource use and quality, rather than volume, of services. The challenges identified are in five key topic...
Permanent Funding Authorities: Some Selected Entities Should Review Financial Management, Oversight, and Transparency Policies
GAO-17-59: Published: Dec 9, 2016. Publicly Released: Dec 9, 2016.
Permanent authorities to collect and obligate fees, fines, penalties and other funds without further congressional action vary in the degree to which Congress retains control over collections and obligations or delegates control to the entities that administer them. For the purposes of this report, GAO refers to these legal authorities as permanent funding authorities. GAO examined five case studi...
Prescription Drug Labels: Actions Needed to Increase Awareness of Best Practices for Accessible Labels for Individuals Who are Blind or Visually Impaired
GAO-17-115: Published: Dec 9, 2016. Publicly Released: Dec 9, 2016.
GAO found that some pharmacies can provide accessible prescription drug labels, which include labels in audible, braille, and large print formats and are affixed to prescription drug containers.Mail order pharmacies: Four pharmacy benefit managers (PBMs) used by large insurers that GAO contacted reported that they can provide accessible labels through their mail order pharmacies.Retail pharmacies...
DATA Act: Implementation Progresses but Challenges Remain
GAO-17-282T: Published: Dec 8, 2016. Publicly Released: Dec 8, 2016.
The Office of Management and Budget (OMB), the Department of the Treasury (Treasury), and federal agencies have taken steps to implement the Digital Accountability and Transparency Act of 2014 (DATA Act); however, more work is needed for effective implementation.Data governance and the transition to a new administration. OMB and Treasury have established a new Data Standards Committee responsible...
Data Act: OMB and Treasury Have Issued Additional Guidance and Have Improved Pilot Design but Implementation Challenges Remain
GAO-17-156: Published: Dec 8, 2016. Publicly Released: Dec 8, 2016.
Data governance and the transition to the new administration. Consistent with a July 2015 GAO recommendation to establish clear policies and processes that follow leading practices for data governance under the Digital Accountability and Transparency Act of 2014 (DATA Act), the Office of Management and Budget (OMB) and the Department of the Treasury (Treasury) have taken the initial step of conve...
Federal Building Management: Building Disposal Authorities Provide Varying Degrees of Flexibility and Opportunities for Use
GAO-17-123: Published: Dec 8, 2016. Publicly Released: Dec 8, 2016.
Twenty civilian federal entities reported they have at least one statutory authority that allows them to dispose of federally owned buildings under their control. Fifteen entities reported the authority to retain proceeds from building disposals. However, most of these federal entities reported limited use of their independent authorities during fiscal years 2011 through 2015. Seven entities that...
Littoral Combat Ship and Frigate: Slowing Planned Frigate Acquisition Would Enable Better-Informed Decisions
GAO-17-279T: Published: Dec 8, 2016. Publicly Released: Dec 8, 2016.
The Navy's vision for the Littoral Combat Ship (LCS) program has evolved significantly over the last 15 years, reflecting degradations of the underlying business case. Initial plans to experiment with two different prototype ships adapted from commercial designs were abandoned early in favor of an acquisition approach that committed to numerous ships before proving their capabilities. Cost, schedu...
State and Local Governments' Fiscal Outlook: 2016 Update
GAO-17-213SP: Published: Dec 8, 2016. Publicly Released: Dec 8, 2016.
GAO’s State and Local Fiscal SimulationsFiscal sustainability presents a national challenge shared by all levels of government. GAO’s simulations of long-term fiscal trends in the state and local government sector—published since 2007—have consistently shown that state and local governments face long-term fiscal pressures driven largely by the rising health-related costs of Medicaid and th...
Defense Business Transformation: DOD Should Improve Its Planning with and Performance Monitoring of the Military Departments
GAO-17-9: Published: Dec 7, 2016. Publicly Released: Dec 7, 2016.
The Department of Defense (DOD) and the military departments have established roles and responsibilities for senior business transformation positions, such as Chief Management Officers (CMOs) and Deputy CMOs (DCMOs), who are responsible for business transformation efforts—actions to increase the efficiency of or to decrease the costs associated with DOD's business functions, such as acquisitions...
Freight Rail Pricing: Contracts Provide Shippers and Railroads Flexibility, but High Rates Concern Some Shippers
GAO-17-166: Published: Dec 7, 2016. Publicly Released: Dec 7, 2016.
While rail contracts and tariffs are similar, contracts offer the flexibility to customize rates and terms to a specific shipper, according to selected stakeholders GAO interviewed. Both contract and tariff rates are based on market factors, such as competition, according to representatives from the four largest U.S. freight railroads. However, they noted that in developing contract rates, a railr...