Successful Reform Requires Meeting Key Management Challenges

GAO-01-1006T: Published: Jul 25, 2001. Publicly Released: Jul 25, 2001.

Additional Materials:


Laura A. Dummit
(202) 512-8942


Office of Public Affairs
(202) 512-4800

Management of Medicare has come under increasing scrutiny. The Health Care Financing Administration (HCFA) has had mixed success running the program. The agency has developed payment methods that have contained cost growth, and HCFA has paid fee-for-service claims quickly and at low administrative cost. However, HCFA has had difficulty ensuring that it paid claims appropriately. In addition, Medicare claims administration contractors have done a poor job of communicating with Medicare providers. HCFA has taken important steps to address some of these shortcomings, including strengthening payment safeguards, but several factors have hampered its efforts. Despite its growing responsibilities, HCFA suffers from staffing shortages. The agency also continues to rely on archaic computer systems. At the same time, HCFA has faltered in its attempts to adopt a results-based approach to agency management. Constraints on the agency's contracting authority have limited its use of full and open competition to select claims administration contractors and assign administrative tasks. Rising expectations among Medicare beneficiaries and providers are putting pressure on the Centers for Medicare and Medicaid Services to modernize and improve agency operations. Such improvements will require HCFA to begin a performance-based management approach that holds managers accountable for achieving program goals. Congressional attention also appears warranted if Medicare is to meet the challenges of the 21st century.

Feb 16, 2018

Jan 30, 2018

Dec 12, 2017

Nov 21, 2017

Nov 20, 2017

Nov 8, 2017

Oct 31, 2017

Oct 26, 2017

Oct 17, 2017

Oct 12, 2017

Looking for more? Browse all our products here