HCFA Research:

Agency Practices and Other Factors Threaten Quality of Mandated Studies

PEMD-88-9: Published: Jun 3, 1988. Publicly Released: Jun 27, 1988.

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Pursuant to a congressional request, GAO: (1) assessed the relevance, timeliness, and technical adequacy of the Health Care Financing Administration's (HCFA) congressionally mandated research and evaluation activities; and (2) identified key internal and external factors that influenced the HCFA Office of Research and Demonstrations' (ORD) management and dissemination practices.

GAO found that ORD: (1) frequently did not fully respond to the information needs that caused Congress to mandate the report; (2) failed to develop systematic communications with Congress to clarify congressional mandates; (3) sometimes reduced reports' relevance by changing initial study plans and scope; (4) improved earlier report timeliness problems, but still experienced substantial delays during the study execution and report review phases; and (5) inconsistently applied practices for ensuring technical adequacy during project planning and execution and report review. GAO also found that factors affecting the quality of ORD reports included: (1) lack of communication between HCFA and Congress; (2) ORD failure to consider congressional interests during project planning; (3) lack of adequate monitoring; and (4) HCFA reductions in funding and staff.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: The Department of Health and Human Services (HHS) plan for increased communication with congressional requestors remains too vague.

    Recommendation: The Secretary of Health and Human Services should direct the Administrator, HCFA, to develop internal management procedures that will address the issues raised in this report. This would include, for example, procedures to ensure that agency communication with appropriate congressional committees is adequate during all stages of mandated studies and that ORD considers areas of congressional concern in developing its research and evaluation plans.

    Agency Affected: Department of Health and Human Services

  2. Status: Closed - Not Implemented

    Comments: It has been more than 3 years since the report was issued.

    Recommendation: The Secretary of Health and Human Services should implement formal report review procedures designed to ensure that HHS reviews of reports to Congress will be timely.

    Agency Affected: Department of Health and Human Services

  3. Status: Closed - Implemented

    Comments: HHS still has not reached any conclusions as to resource needs.

    Recommendation: The Secretary of Health and Human Services should direct the Administrator, HCFA, to assess whether ORD has sufficient staff and resources to plan, monitor, and review studies mandated by Congress, as well as those supported by discretionary funds.

    Agency Affected: Department of Health and Human Services

  4. Status: Closed - Not Implemented

    Comments: It has been more than 3 years since the report was issued.

    Recommendation: The Secretary of Health and Human Services should work with other executive branch agencies to develop similar procedures for reviewing HCFA reports.

    Agency Affected: Department of Health and Human Services

 

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