GAO’s Health Care Team

Posted on June 27, 2014
GAO’s workforce is organized largely by subject area, with most employees working in 1 of 14 mission teams. Today, we’ll be putting the spotlight on the Health Care team, which supports congressional oversight of federal agencies responsible for health care delivery and financing. These programs tangibly affect the lives of all Americans. Expenditures on federal health care programs represent about a quarter of all federal spending each year. Ensuring that these programs provide access to quality care, protect the public, and remain fiscally sustainable is one of the greatest challenges facing Congress and the President in the 21st century. Reports The Health Care team’s reports cover five main issue areas:
  • Military and Veterans’ Health Care
o   A report and congressional testimonies examined the Department of Veterans Affairs’ management of medical appointment scheduling and wait times. This has affected the agency’s ability to provide timely access to needed care for veterans and, in some cases, has resulted in harm to patients.
  • Public Health
o   The Health Care team issued a report and testified at a Congressional hearing about prescription drug shortages, which have led to prolonged duration of disease, permanent injury, and even patient death.
  • Private Insurance
o   This report is one of many looking at private health insurance in the context of the Patient Protection and Affordable Care Act (PPACA) and other related federal and state health care laws.
  • Medicare
o   For example, one report looked at the effects of continuous health insurance coverage prior to enrollment in Medicare.
  • Medicaid
o   A recent report studied characteristics of high-expenditure Medicaid beneficiaries. You can learn even more about our work by checking out our Key Issue pages. Just click the “Health Care” box on this page to see our pages about health care quality and access, public health emergency preparedness and response, and more. Impact In fiscal year 2013, the Health Care team’s work identified $2.6 billion in financial benefits for the federal government as well as 58 improvements agencies made in response to our recommendations. So far in fiscal year 2014, directors have testified at 16 Congressional hearings on topics such as Medicare program integrity, patient safety risks for veterans, and federal investments in health care workforce training programs. A Closer Look at a Health Care Report: Public Health Threats of Prescription Drug Shortages Over the last decade, an increasing number of prescription drugs—including life-saving and -sustaining drugs—have been in short supply. As a result, health care providers, such as your doctor or pharmacy, may have to use less effective medications or ones with unwanted side-effects, if alternatives are available at all. Chart1

Excerpted from GAO-14-194

The immediate cause of these new and ongoing drug shortages can generally be traced to a manufacturer who halts or slows production to address quality problems, leading to a supply disruption that other manufacturers don’t have the capacity to offset. In addition, low profit margins for certain drugs have limited manufacturers’ infrastructure investments or led some to exit the market entirely. The Food and Drug Administration (FDA) is responsible for addressing prescription drug shortages. Although shortages have persisted, the agency has improved its responsiveness and prevented more potential shortages in the last 2 years. However, shortcomings in FDA’s management of drug shortage data could undermine its efforts. We recommended that the agency strengthen its internal controls over its drug shortage data and periodically assess the information to proactively identify drug shortage risk factors. Listen to a podcast and watch the Ask GAO Live chat we recorded with the director of this work:

GAO: AskGAOLive Chat on Prescription Drug Shortages