Management of and Results Obtained From HCFA Demonstrations and Experiments

HRD-80-96: Published: Jul 14, 1980. Publicly Released: Jul 14, 1980.

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A review was made of management and results obtained from demonstrations and experiments (D&E) and related evaluations by the Health Care Financing Administration.

The results indicated that the D&E activities of the Health Care Financing Administration's Office of Research, Demonstrations, and Statistics has fallen short of expectations and requirements of the cognizant legislative committees of Congress. Reports to Congress have not been submitted by the dates specified by law. The reports did not meet the specifications contained in the law or related committee reports. More recent mandated demonstrations have not been undertaken because of shortages of staff or money. The review indicated that these projects had an impact on the development of such legislative initiatives as the administration's hospital cost containment proposals, the development of regulations to implement laws, and a regulation change that would significantly reduce Medicare payments to hospitals. The Office of Research has not complied with the requirements or used the authority, in all cases, which it received in this legislation. The processes for carrying out the D&E activities often require long periods of time, which may partly explain the problem of meeting congressional expectations, but the office needs to modify its processes for carrying D&E activities to help improve the utilization of the results.

Recommendation for Executive Action

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Secretary of Health and Human Services should direct the Administrator of the Health Care Financing Administration to implement the following recommendations aimed at improving the Office of Research, Demonstrations, and Statistics processes, which should in turn help improve the use of D&E results. He should provide for more involvement of policymakers and program officials in the Office of Research, Demonstrations, and Statistics planning process; identify during the planning process the knowledge needed to respond to specific policy issues, adjust the planning and project design processes to adapt to congressionally mandated D&E; obtain and retain raw D&E data when they are likely to prove useful in future research and verify the data on a sample basis; establish a control and tracking system that identifies the interim D&E results of ongoing projects by subject matter; take a formal position on the results reported from each project; make a systematic ongoing assessment of the utilization and outcomes of D&E activities; and establish procedures to account for the time professional staff spend in carrying out their various tasks and establish performance standards for project officers and managers.

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