Health Systems Plans

A Poor Framework for Promoting Health Care Improvements Gao ID: HRD-81-93 June 22, 1981

The National Health Planning and Resources Development Act established health systems agencies (HSA) with responsibility for planning health services within a particular geographic area. The Act also established State health planning and development agencies and statewide health coordinating councils to deal with health care needs from the perspective of the entire State. The adequacy of health systems plans developed by HSA were reviewed and actions were recommended that the Department of Health and Human Services (HHS) should take to improve the plans.

A high priority of each HSA is to develop a health systems plan, a document describing what needs to be done to improve the health care system and the health status of area residents. The plan is fundamental for accomplishing the HSA objective. Despite substantial resources and community effort, GAO found that: (1) health systems plans were inadequately developed; (2) objectives lacked measurability; (3) objectives were not limited to priority goals; (4) many more objectives were established than could be accomplished within a reasonable timeframe; (5) objectives were questionable because they concerned further planning or were unattainable or unrealistic in what they sought to achieve through local community resources; (6) recommended actions for accomplishing objectives were nonexistent or poorly developed; and (7) resource requirements for implementing each recommended action were unspecified or inadequate. The failure of HSA's to follow HHS guidance and insufficient HHS involvement with HSA's during plan development contributed to the inadequacy of the plans. GAO also found that statewide roles for HSA vary widely and that the impact of the program is difficult to assess. This means that it may be impossible to produce clear and dramatic evidence concerning the effectiveness of health planning organizations.

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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