image by: U.S. Department of Health and Human Services

HWN Suggests

Reducing Administrative Waste in the US Health Care System

Because the US health care system is so fragmented, there is not a clearly dominant entity to set administrative standards and force adoption. The federal government is the largest payer, but its market power is not concentrated because its payments flow through hundreds of different programs, including 50 unique Medicaid programs, Medicare, hundreds of Medicare Advantage plans, ACA insurance exchanges, federal employee health benefits, the military health system, Veterans Affairs, and the Indian Health Service

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Articles of Interest

Downsizing the Federal Government

The Department of Health and Human Services runs the huge and fast-growing Medicare and Medicaid. These programs fuel rising health costs, distort markets, and are plagued by waste and fraud.

HHS OIG Admits: We’re Just Flushing Money Down the Drain

The U.S. Department of Health and Human Services Office of the Inspector General (OIG) admitted last week that the Centers for Medicare and Medicaid Services (CMS) hospital payment process is broken.

Management Challenge 2: Transitioning to Value-Based Payments for Health Care

There is widespread agreement among experts that the incentives created by paying for health care based on the volume of items or services furnished, generally known as a fee-for-service system, contributes to waste in health care by encouraging unnecessary utilization and fragmented, poor quality care.

Why Healthcare Waste Is A Major Problem In The United States

According to a study by the National Bureau of Economic Research, an estimated $765 billion worth of medical supplies are wasted every year in the United States. This includes everything from unused medications to unneeded medical procedures.

Why It’s So Hard to Cut Waste in Health Care

Cutting waste while preserving critically important treatment is the holy grail of health care policy. The coronavirus pandemic has shown why that goal has been so stubbornly difficult to achieve.

Resources

Department of Health & Human Services OIG

The U.S. Department of Health and Human Services (HHS) Office of Inspector General's (OIG) mission is to protect the integrity of HHS programs as well as the health and welfare of program beneficiaries. In doing so, we rely on complaints by HHS employees, contractors, subcontractors, grantees and subgrantees (i.e. whistleblowers) who report fraud, waste, abuse or mismanagement in HHS programs. We also review and investigate reports of whistleblower retaliation.

HHS

The mission of the U.S. Department of Health and Human Services (HHS) is to enhance the health and well-being of all Americans, by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services.