Going into the new year, the HHS Office of Inspector General (OIG) will continue to focus on administration, quality health care, program integrity, and the improvement of electronic health records (EHR) and health information technology (IT). The OIG has identified its top 10 management and performance challenges, and has expressed its commitment to assisting in transitioning between administrations.
The OIG finds effective administration to be a challenge in many areas. The Medicaid program is a particular area of concern due to the 72 million enrollees that the program serves and the expansions implemented under the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148). In particular, CMS needs complete and accurate data about managed care, states need to fully implement all program integrity tools, and corrective action plans to address improper payments must be developed. These issues are representative of the OIG’s challenges in operating the entirety of HHS, which reported total costs of about $1 trillion in fiscal year (FY) 2015. The OIG must continue taking corrective actions, resolving deficiencies, and monitoring contracts. Other particular administrative challenges are grants, the health insurance marketplaces, and Part A and Part B program integrity.
The OIG faces several issues within the realm of IT. Cybersecurity has been a growing concern due to the significant increase in the frequency of data breaches. Additionally, despite HHS’ investments in health IT and interoperability, the agency still has steps to take to ensure widespread use and adoption of EHRs and other health IT. The rest of the top challenges focus on serving the population: ensuring that vulnerable populations receive quality care; monitoring food, drug, and medical device safety; and addressing drug abuse in Part D and Medicaid.