The Health and Human Services Department is shelling out billions of dollars on three new federal programs that essentially do the same thing.
The Affordable Care Act provides funding toward new initiatives aimed at improving the quality of care. But a new report from the HHS Inspector General found that at least three other programs that serve essentially the same purpose are being used by many of the same hospitals.
Because of this, the inspector general said the agency is paying significantly more than it should be to achieve the same results.
CMS has a $4 billion contract with quality improvement organizations that are set up to help improve care and reduce readmission rates at hospitals. Some of the work they do includes reducing the use of physical restraints in nursing homes and increasing the use of electronic health records. But many of the hospitals collaborating with those organizations are also involved in two separate federal programs that provide the same or similar services. Those programs—the Hospital Engagement Networks and the Community-Based Care Transition Program---have cost about $500 million to set up.
The report claims that 80 percent of the hospitals that collaborated with quality improvement organizations also collaborated with the two federal programs in 2013. Over that same time period, 85 percent of hospitals that partnered with the organizations also worked with independent entities like insurers and state and local government programs for similar purposes.
The auditors said that the overlap of programs not only wastes money but also makes it difficult to measure which programs are most effective. They criticized CMS for not having better management over the programs and their partner hospitals.
“The overlap among CMS’s quality improvement efforts raises concerns about how well CMS coordinates those efforts,” the inspector general said.
“It is important to note that focus on the same goals through different means does not necessarily equate to duplication, waste or inefficiency,” CMS officials said in their response to the report.
Duplication among federal programs is nothing new. Last year, the Government Accountability Office estimated that the government spent about $45 billion in redundant federal programs. The GAO keeps a list of the agencies that are most fraught with overlap and duplication and the Health and Human Services Department is no stranger to that list.
Last year, the auditors reported that 10 different agencies within HHS provide similar services relating to AIDS outreach in minority communities while 11 different agencies perform autism research without properly coordinating their efforts.
The latest IG report just adds a few new programs to that list. “Our findings underscore that overlap remains a concern,” the auditors said.
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