A recent report from the HHS Office of Inspector General details the top 10 management and performance challenges facing the department.
The identified topics are in various HHS programs. As the 48-page report reads, the department “should be mindful of these challenges and opportunities to address them as it undertakes its efforts to reimagine HHS as part of the federal government’s comprehensive plan to reform government.”
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Here are the top issues, according to the report:
- Ensuring program integrity in Medicare. In fiscal year 2016, Medicare covered 56.8 million lives and spent a total of $679 billion. This spending is only expected to increase. To improve the program, HHS must reduce improper payments, combat fraud, build up prudent payment policies and implement healthcare reforms and health IT.
- Ensuring program integrity in Medicaid. During the same fiscal year, combined federal and state Medicaid spending hit $574 billion. Nearly 69 million people were enrolled. The main aspects of this challenge include establishing compliance with fiscal controls, utilizing fraud prevention tools and improving overall national Medicaid data.
- Curbing the opioid epidemic. The CDC found that in 2015, more than 33,000 individuals died from overdoses involving opioids. OIG encourages HHS to address myriad issues, including the inappropriate prescribing of opioids, diversion of prescription opioids and fraud by providers of treatment for opioid abuse disorder. Additionally, the report urges the department to take a closer look at inadequate patient access to treatment and the misuse of grant funds.
- Improving care for vulnerable populations. Though it seems broad, the report breaks this challenge down into four categories. The first two include reducing substandard nursing home care and decreasing problems in hospice care. OIG also believes HHS should strive to mitigate risks in home-based services and ensure access to safe services for children.
- Ensuring integrity in managed care and other programs delivered through private insurers. The primary components of this task are combating fraud and abuse by providers billing managed care plans, guaranteeing compliance with managed care and Medicare Part D sponsors and overseeing the health insurance marketplaces.
- Improving financial and administrative management and reducing improper payments. Addressing weaknesses in financial management systems, reducing improper payments and implementing the Digital Accountability and Transparency Act are what OIG suggests HHS do to overcome such an issue.
- Protecting the integrity of public Health and Human Services grants. HHS awarded more than $100 billion in grants (excluding Medicaid) in fiscal year 2016. To ensure continued success in this realm, HHS should make sure grants are properly managed within the department and manage program integrity and financial capability at the grantee level.
- Ensuring the safety of food, drugs and medical devices. Another broad challenge, this point brings in the FDA. The agency should monitor food facilities, implement the 21st Century Cures Act and oversee the drug and medical device supply chain.
- Ensuring program integrity and quality in programs serving American Indian and Alaska Native populations. HHS administered 45 percent of all federal funds (a total of $7 billion) that serve American Indian and Alaska Native communities. In addition to combating the misuse of funds, OIG recommends HHS improve the quality of care for these populations.
- Protecting HHS data, systems and beneficiaries from cybersecurity threats. As cybersecurity becomes a growing issue, it’s crucial that HHS keep its information safe. Another aspect of this challenge includes fostering a culture of cybersecurity at HHS and with its partners and stakeholders.
Photo: nevarpp, Getty Images
