Physician Shortage Areas: Medicare Incentive Payment Not an Effective Approach to Improve Access
HEHS-99-36
Published: Feb 26, 1999. Publicly Released: Feb 26, 1999.
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Highlights
Pursuant to a congressional request, GAO reviewed the Medicare Incentive Payment program to determine if: (1) it is an effective mechanism for improving access to care for Medicare beneficiaries and underserved populations other than Medicare beneficiaries; and (2) the program's goals, performance measures, and financial controls provide a sound structure for continuing or expanding the program.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| Congress should consider whether the Medicare Incentive Payment program is an appropriate vehicle for addressing medical underservice. If Congress decides to continue or expand the program, it should consider clarifying the intent of the program and taking steps to better structure the program to link limited federal funds to the intended outcomes. |
Closed – Not Implemented
|
Congress took action to make the bonus payment automatic without addressing our recommendation to take steps to better structure the program to better link the payments to intended outcomes. |
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | To improve management and oversight of the program, the Secretary of Health and Human Services should: (1) integrate the program into the Department's overall access-to-care strategic planning and performance measurement activities; and (2) direct the Administrator of HCFA to establish more intensive bonus payment review standards for all contractors. |
Closed – Not Implemented
In response to GAO inquiries, CMS did not identify action to implement recommendation.
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Topics
Cost effectiveness analysisHealth care programsHealth care servicesInternal controlsMedical feesMedicarePerformance measuresPhysiciansProgram beneficiariesPrimary care