Three federal healthcare projects spent an estimated $1 billion to improve the quality of hospitals, but much of the effort was wasted because of duplication.
The Centers for Medicare and Medicaid Services contracted with the organizations to improve infection rates and readmissions in hospitals and simultaneously launched two programs that each took on the same mission, according to the Department of Health and Human Services inspector general report. Consequently, the government paid three times for the same project.
“Data problems and timing of other CMS quality improvements hampered [organizations’] ability to target eligible hospitals and avoid duplicating those efforts,” the inspector general said.
Reducing such overlap among the programs “could lead to better use of limited federal funds and more targeted assistance to hospitals in need of improvement. CMS should further coordinate efforts to ensure that they are complementary and not duplicative.”
Duplication of effort is a widespread problem in government healthcare. In 2013, more than 80 percent of the hospitals that partnered with quality improvement organizations also participated with other similar federal programs.
Additionally, in the same year, 85 percent of hospitals working with the organizations also collaborated with entities independent of the federal government, such as insurers and state and local government programs.
“The overlap among CMS’s quality improvement efforts raises concerns about how well CMS coordinates those efforts,” the inspector general said.
A 2011 Medicare Payment Advisory Commission report to Congress found that duplicative programs reduced a hospital’s ability to participate in projects initiated by quality improvement organizations. MedPAC recommended that hospitals receive funding for such efforts directly from the government.
“This funding would enable those providers to select the entities that best fit their quality improvement needs,” the inspector general’s report said.
Without remedial management actions, even more waste of tax dollars will likely result because CMS recently entered into a new 5-year, $4 billion contract with quality improvement organizations.
Despite agreeing with the inspector general’s recommendations, CMS officials defended their current policies.
“It is important to note that focus on the same goals through different means does not necessarily equate to duplication, waste or inefficiency,” CMS said in its response to the inspector general.
Other reports have focused on waste due to duplication such as a 2012 Government Accountability Office assessment, but CMS has done little to solve the problem.
“Our findings underscore that overlap remains a concern,” the inspector general said.
