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    Results:

    Subject Term: "Medical economic analysis"

    4 publications with a total of 5 open recommendations
    Director: Brenda S. Farrell
    Phone: (202) 512-3604

    2 open recommendations
    Recommendation: To help ensure that DOD has the necessary information to determine the extent to which cost savings result from any future consolidation of training within METC or the Education and Training Directorate, the Assistant Secretary of Defense for Health Affairs should direct the Director of the DHA to develop baseline cost information as part of its metrics to assess achievement of cost savings.

    Agency: Department of Defense: Office of the Assistant Secretary of Defense (Health Affairs)
    Status: Open

    Comments: The House Report Accompanying the National Defense Authorization Act for Fiscal Year 2015, citing our work on this subject, required DOD to submit a report by January 31, 2015 detailing, among other things, an explanation of the purpose and goals of the medical education and training shared service with regard to its role in improving the cost efficiency of delivering training, including the challenges it will address, the practices it will put in place to address these challenges, and the resulting cost savings. However, as of September 2015, DOD has not submitted this report. Until DOD develops baseline cost information as part of its metrics to assess achievement of cost savings, this recommendation should remain open.
    Recommendation: To help realize the reform effort's goal of achieving cost savings, the Assistant Secretary of Defense for Health Affairs should direct the Director of the DHA to conduct a fully developed business case analysis for the Education and Training Directorate's reform effort. In this analysis the Director should (1) identify the cost-related problem that it seeks to address by establishing the Education and Training Directorate, (2) explain how the processes it has identified will address the costrelated problem, and (3) conduct and document an analysis of benefits, costs, and risks.

    Agency: Department of Defense: Office of the Assistant Secretary of Defense (Health Affairs)
    Status: Open

    Comments: The House Report Accompanying the National Defense Authorization Act for Fiscal Year 2015, citing our work on this subject, required DOD to submit a report by January 31, 2015 detailing, among other things, an explanation of the purpose and goals of the medical education and training shared service with regard to its role in improving the cost efficiency of delivering training, including the challenges it will address, the practices it will put in place to address these challenges, and the resulting cost savings. However, as of September 2015, DOD has not submitted this report. We reported in September 2015 that DOD has not yet presented a fully developed business case for its Medical Education and Training shared service. Until DOD addresses these concerns, this recommendation should remain open.
    Director: Yocom, Carolyn L
    Phone: (202)512-4931

    1 open recommendations
    Recommendation: To ensure that federal funding efficiently and effectively responds to the countercyclical nature of the Medicaid program, Congress may wish to consider enacting an FMAP formula that is targeted for variable state Medicaid needs and provides automatic, timely, and temporary increased FMAP assistance in response to national economic downturns.

    Agency: Congress
    Status: Open

    Comments: On February 10, 2016, GAO testified on considerations related to the Medicaid funding formula. See Medicaid: Changes to Funding Formula Could Improve Allocation of Funds to States GAO-16-377T January 26, 2016. We also cited this report in our discussion on Medicaid funding during economic downturns in Medicaid: Key Policy and Data Considerations for Designing a Per Capita Cap on Federal Funding(GAO-16-726).
    Director: Cosgrove, James C
    Phone: (202)512-7029

    1 open recommendations
    Recommendation: To ensure that savings are realized from the implementation of an MPPR or other policies that reflect efficiencies occurring when services are furnished together, Congress may wish to consider exempting these savings from budget neutrality.

    Agency: Congress
    Status: Open

    Comments: As of May 2017, we are awaiting an update from HHS on the status of this recommendation. We will update the status of this recommendation when we receive additional information.
    Director: Steinwald, Alan Bruce
    Phone: (202)512-3000

    1 open recommendations
    Recommendation: Given the contribution of physicians to Medicare spending in total, the Administrator of CMS should develop a profiling system that identifies individual physicians with inefficient practice patterns and, seeking legislative changes as necessary, use the results to improve the efficiency of care financed by Medicare. The profiling system should include methods for measuring the impact of physician profiling on program spending and physician behavior.

    Agency: Department of Health and Human Services: Centers for Medicare and Medicaid Services
    Status: Open

    Comments: Physician feedback reporting was initiated under section 131(c) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), and was expanded by section 3003 of the Patient Protection and Affordable Care Act (PPACA). In addition, PPACA required the Department of Health and Human Services to coordinate the physician feedback program with a Value Modifier (VM) that will adjust fee-for-service physician payments for the relative quality and cost of care provided to beneficiaries. In 2012, CMS provided Quality and Resource Use Reports (QRUR) to large providers nationwide and physician-focused QRURs to groups with 25 or more eligible providers in 9 states; by 2014, CMS sent QRURs to all group practices and solo practitioners. Also, as required in the act, CMS applied the VM to select physicians in 2015, with all physicians being subject to VM by 2017. The Act requires the VM to be implemented in a budget neutral manner, meaning that any upward payment adjustments for high performance must balance the downward payment adjustments applied for poor performance. CMS officials said they develop and will continue to develop experience reports related to each year's QRUR/VM cycle. In 2015, CMS used VM results for physicians in groups of 100 or more in public engagement of stakeholders, encouraging them to report quality, because quality performance was the driver of the payment adjustments in 2015. CMS is working with its Center for Clinical Standards and Quality to think of how to better engage physicians and groups in reporting, to avoid the automatic downward adjustment. As the program gains experience, CMS will use the experience reports to examine the impact of QRURs and VM on the Medicare program. In order for this recommendation to be closed as implemented, CMS will need to expand its efforts to measure the impact of QRURs and VM on program spending and physician behavior.