Health Care Access

The Rural Health Clinic Program and other federal programs often provide aid to communities without ensuring that this assistance has been used to improve access to primary care. In some cases, programs have provided more than enough assistance to eliminate the defined shortage, while needs in other communities have gone unaddressed. GAO has identified a pervasive cause for this problem: a reliance on flawed systems for measuring health care shortages. These systems often fall short in identifying which programs would work best in a particular setting or how well a program meets the needs of the underserviced once it is in place. For several years, the Department of Health and Human Services has tried unsuccessfully to overcome these problems. The goal-setting and performance measurement discipline prescribed by the Government Performance and Results Act should help make programs more accountable for improving access to primary care.

GAO noted that: (1) GAO's work has identified many instances in which the Rural Health Clinic program and other federal programs have provided aid to communities without ensuring that this aid has been used to improve access to primary care; (2) in some cases, programs have provided more than enough assistance to eliminate the defined shortage, while needs in other communities remain unaddressed; (3) GAO's work has identified a pervasive cause for this proa reliance on flawed systems for measuring health care shortages; (4) these systems often do not work effectively to identify which programs would work best in a given setting or how well a program is working to meet the needs of the underserved once it is in place; (5) for several years, the Department of Health and Human Services has tried unsuccessfully to revise these systems to address these problems; and (6) the goal-setting and performance measurement discipline available under the Results Act, however, appears to offer a suitable framework for ensuring that programs are held accountable for improving access to primary care.