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VETERANS’ HEALTH CARE - Preliminary Observations on VHA’s Claims Processing Delays and Efforts to Improve the Timeliness of Payments to Community Providers
Due to increases in expenditures and utilization of VA care in the community services in recent years, VHA has had difficulty processing claims in a timely manner. In planning to consolidate its ... existing VA care in the community programs, as required by law, the agency said it will examine strategies for improving the timeliness and accuracy of its payments to community providers.<br ... /> This statement, which is based on ongoing work, summarizes GAO’s preliminary observations about (1) VHA’s, Medicare’s, and TRICARE’s claims processing timeliness in fiscal year 2015; (2) factors that have impeded ... Data processing hold back by technology limitation, workload and administrative burden ... US GAO analyzed all factors of slower processing and user unfriendliness that occur sometimes to the veterans healthcare. The main focus is data processing - and it has been proved that it can ... be failing not only because of technology, but also because of work-process design, staff and organisation.
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Due to increases in expenditures and utilization of VA care in the community services in recent years, VHA has had difficulty processing claims in a timely manner. In planning to consolidate its ... existing VA care in the community programs, as required by law, the agency said it will examine strategies for improving the timeliness and accuracy of its payments to community providers.<br ... /> This statement, which is based on ongoing work, summarizes GAO’s preliminary observations about (1) VHA’s, Medicare’s, and TRICARE’s claims processing timeliness in fiscal year 2015; (2) factors that have impeded ... Data processing hold back by technology limitation, workload and administrative burden ... US GAO analyzed all factors of slower processing and user unfriendliness that occur sometimes to the veterans healthcare. The main focus is data processing - and it has been proved that it can ... be failing not only because of technology, but also because of work-process design, staff and organisation.
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General Accountability Office
, issued in 2016
Risk cases: 6
Conflicts of interest
First, recognise the conflicts of interest are a real risk the British NAO gathered a significant amount of intelligence on conflicts, particularly in the health and education sectors. These are areas of government where services are increasingly commissioned and delivered by parties at arm’s-length to departments. Conflicts of interest can occur naturally as a product of the way a system is designed and most often arise from operational situations.
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First, recognise the conflicts of interest are a real risk the British NAO gathered a significant amount of intelligence on conflicts, particularly in the health and education sectors. These are areas of government where services are increasingly commissioned and delivered by parties at arm’s-length to departments. Conflicts of interest can occur naturally as a product of the way a system is designed and most often arise from operational situations.
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National Audit Office
, issued in 2015
Risk cases: 8
Use of consultants and temporary staff
New skills needed in a longer term UK NAO: Used well, consultants and temporary staff can be an important source of specialist skills and capabilities that are uneconomic for departments to maintain in their permanent staff. Since 2009-10, the government has used spending controls to reduce its use of consultants and temporary staff, and by 2014-15 spending had fallen by £1.5 billion. However, spending has increased by between £400 million and £600 million since 2011-12, suggesting that this was more of a short-term reduction than a sustainable strategy. In the longer term, departments will need to develop workforce, skills and capacity plans to reduce their dependence on external skills. They will need to improve their strategic workforce planning to determine where they can deploy existing staff, where they need to recruit, and where they need to engage temporary resources. Without this, departments cannot demonstrate that they are achieving value for money from the use of consultants and temporary staff.
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New skills needed in a longer term UK NAO: Used well, consultants and temporary staff can be an important source of specialist skills and capabilities that are uneconomic for departments to maintain in their permanent staff. Since 2009-10, the government has used spending controls to reduce its use of consultants and temporary staff, and by 2014-15 spending had fallen by £1.5 billion. However, spending has increased by between £400 million and £600 million since 2011-12, suggesting that this was more of a short-term reduction than a sustainable strategy. In the longer term, departments will need to develop workforce, skills and capacity plans to reduce their dependence on external skills. They will need to improve their strategic workforce planning to determine where they can deploy existing staff, where they need to recruit, and where they need to engage temporary resources. Without this, departments cannot demonstrate that they are achieving value for money from the use of consultants and temporary staff.
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National Audit Office
, issued in 2016
Risk cases: 7
Australian Taxation Office: Administration of Australian Business Number Registrations
More elligibility and data integrity needed The Australian Business Number (ABN) and Australian Business Register initiatives were implemented as part of theGovernment's comprehensive reform of the taxation system in 2000. Their introduction involved challenging issues of technology and governance , including the imperative to process and register significant numbers of applications in a short time. Overall, the Australian SAI concluded that the ABN registration process is operating effectively. However, matters relating to the eligibility of some ABN applicants need to be reviewed. Further, some data integrity issues remain outstanding.
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More elligibility and data integrity needed The Australian Business Number (ABN) and Australian Business Register initiatives were implemented as part of theGovernment's comprehensive reform of the taxation system in 2000. Their introduction involved challenging issues of technology and governance , including the imperative to process and register significant numbers of applications in a short time. Overall, the Australian SAI concluded that the ABN registration process is operating effectively. However, matters relating to the eligibility of some ABN applicants need to be reviewed. Further, some data integrity issues remain outstanding.
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The Australian National Audit Office
, issued in 2003
Risk cases: 3
Building and Implementing the Phoenix Pay System
Expensive IT project became a failure Phoenix project (development of states pay system) was an incomprehensible failure of project management and oversight. Phoenix executives prioritized certain aspects, such as schedule and budget, over other critical ones, such as functionality and security. Phoenix executives did not understand the importance of warnings that the Miramichi Pay Centre, departments and agencies, and the new system were not ready. They did not provide complete and accurate information to deputy ministers and associate deputy ministers of departments and agencies, including the Deputy Minister of Public Services and Procurement, when briefing them on Phoenix readiness for implementation.
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Expensive IT project became a failure Phoenix project (development of states pay system) was an incomprehensible failure of project management and oversight. Phoenix executives prioritized certain aspects, such as schedule and budget, over other critical ones, such as functionality and security. Phoenix executives did not understand the importance of warnings that the Miramichi Pay Centre, departments and agencies, and the new system were not ready. They did not provide complete and accurate information to deputy ministers and associate deputy ministers of departments and agencies, including the Deputy Minister of Public Services and Procurement, when briefing them on Phoenix readiness for implementation.
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Office of theAuditor Generalof Canada
, issued in 2018
Risk cases: 3
Open Data Trend Report 2015
How to activate the open data policy The Dutch SAI looks for ways to improve open data practice in the Netherlands. They point at experience of two leading countries: UK and US, and advise to: prepare a concrete action plan, to increase number of mandatory published data, to develop government-wide data inventory and to put open data to work.
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How to activate the open data policy The Dutch SAI looks for ways to improve open data practice in the Netherlands. They point at experience of two leading countries: UK and US, and advise to: prepare a concrete action plan, to increase number of mandatory published data, to develop government-wide data inventory and to put open data to work.
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Netherlands Court of Audits
, issued in 2015
Risk cases: 4
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