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GAO issues “health” reports

GAO issues “health” reports

The Government Accountability Office (GAO) has recently issued two important reports discussing important aspects of the roll-out of the federal exchange and cost-effective preventive measures in U.S. healthcare.

The first report, published on July 30, 2014, examines the problematic roll-out of Healthcare.gov. In this report, entitled “HEALTHCARE.GOV – Ineffective Planning and Oversight Practices Underscore the Need for Improved Contract Management,”  GAO noted that the Centers for Medicare & Medicaid Services (CMS) made several critical mistakes in the development of Healthcare.gov. Among other things, CMS developed the system “without effective planning or oversight practices, despite facing a number of challenges that increased both the level of risk and the need for effective oversight.” In addition, CMS failed to hold contractors fully accountable after “CMS identified major performance issues” with the federal marketplace. GAO also warned that there are still problems associated with the federal marketplace and “[u]nless CMS improves contract management and adheres to a structured governance process, significant risks remain that upcoming enrollment periods could encounter challenges.”

The second report, entitled “Health Prevention: Cost-effective Services in Recent Peer-Reviewed Health Care Literature,” outlines GAO’s review of potential cost-effective preventive health services that could help “patients avoid the onset or worsening of various health conditions” and potentially result in cost savings in the long run. For inclusion in this report, the study had to be a meta-analysis or comparative study in a peer-reviewed journal published between January 2007 and April 2014 that addressed the cost-effectiveness or cost savings associated with preventive services.  A total of 29 studies met these inclusion requirements. According to the report summary, “GAO categorized each service identified in the review into a preventive health type (e.g., clinical intervention, screening, or vaccination), and provided information on the target population, whether a service was cost saving, and whether a service had been recommended by the U.S. Preventive Services Task Force or the Advisory Committee on Immunization Practices.” While GAO provided a summary of the findings from these studies, it did not make any recommendations as to whether to adopt specific measures.

By Fallyn B. Cavalieri and Aaron J. Aisen

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