Management of and Results Obtained From HCFA Demonstrations and Experiments

A review was made of management and results obtained from demonstrations and experiments (D&E) and related evaluations by the Health Care Financing Administration.

The results indicated that the D&E activities of the Health Care Financing Administration's Office of Research, Demonstrations, and Statistics has fallen short of expectations and requirements of the cognizant legislative committees of Congress. Reports to Congress have not been submitted by the dates specified by law. The reports did not meet the specifications contained in the law or related committee reports. More recent mandated demonstrations have not been undertaken because of shortages of staff or money. The review indicated that these projects had an impact on the development of such legislative initiatives as the administration's hospital cost containment proposals, the development of regulations to implement laws, and a regulation change that would significantly reduce Medicare payments to hospitals. The Office of Research has not complied with the requirements or used the authority, in all cases, which it received in this legislation. The processes for carrying out the D&E activities often require long periods of time, which may partly explain the problem of meeting congressional expectations, but the office needs to modify its processes for carrying D&E activities to help improve the utilization of the results.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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