Health Care Access:

Opportunities to Target Programs and Improve Accountability

T-HEHS-97-204: Published: Sep 11, 1997. Publicly Released: Sep 11, 1997.

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GAO discussed the Rural Health Clinic Program in the broader context of GAO's past reviews of federal efforts to improve access to primary health care, focusing on: (1) the common problems GAO found and some recent initiatives to address them; and (2) how the type of management changes called for under the Government Performance and Results Act of 1993 can help the Rural Health Clinic and related programs improve accountability.

GAO noted that: (1) GAO's work has identified many instances in which the Rural Health Clinic program and other federal programs have provided aid to communities without ensuring that this aid has been used to improve access to primary care; (2) in some cases, programs have provided more than enough assistance to eliminate the defined shortage, while needs in other communities remain unaddressed; (3) GAO's work has identified a pervasive cause for this proa reliance on flawed systems for measuring health care shortages; (4) these systems often do not work effectively to identify which programs would work best in a given setting or how well a program is working to meet the needs of the underserved once it is in place; (5) for several years, the Department of Health and Human Services has tried unsuccessfully to revise these systems to address these problems; and (6) the goal-setting and performance measurement discipline available under the Results Act, however, appears to offer a suitable framework for ensuring that programs are held accountable for improving access to primary care.

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