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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 ... VHA’s timeliness in processing claims; (3) community providers’ experiences; and (4) VHA’s recent actions and plans to improve its claims processing and payment timeliness. To conduct its ongoing work ... 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 ... VHA’s timeliness in processing claims; (3) community providers’ experiences; and (4) VHA’s recent actions and plans to improve its claims processing and payment timeliness. To conduct its ongoing work ... 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
The Shared Services Centre
The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The Australian National Audit Office
, issued in 2016
Risk cases: 2
State funds spent on development, operation and using of data centres services
organisational units of the state on buying hosting, server-housing and other related services. The audited period was between 2010 and 2014; where relevant, the preceding period was also scrutinised. Audited ... The aim of the audit was to scrutinise the management of funds spent on building and operating the national data centre (hereinafter “STC1 data centre”), including the expenditure of selected ... entities: Ministry of the Interior (“MoI”); Ministry of Finance (“MoF”); STÁTNÍ TISKÁRNA CENIN, state firm (state banknote printing firm, hereinafter “STC” or “the state firm”). The audit was conducted ... ... Risks steming from uncoordinated strategy ... supply of services, as well as opposite results of workforce reduction. ... SAI of Czech Republic analysed consequences of failures in strategic IT management at the state level. Lack of coordination and implementation rules reduced practical role of the ministry whose task ... was to guard high quality standards for all crucial IT systems in the state administration. Next consecquences were (among others) risk of uneconomical results of large IT investment and risk of inefficient
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organisational units of the state on buying hosting, server-housing and other related services. The audited period was between 2010 and 2014; where relevant, the preceding period was also scrutinised. Audited ... The aim of the audit was to scrutinise the management of funds spent on building and operating the national data centre (hereinafter “STC1 data centre”), including the expenditure of selected ... entities: Ministry of the Interior (“MoI”); Ministry of Finance (“MoF”); STÁTNÍ TISKÁRNA CENIN, state firm (state banknote printing firm, hereinafter “STC” or “the state firm”). The audit was conducted ... ... Risks steming from uncoordinated strategy ... supply of services, as well as opposite results of workforce reduction. ... SAI of Czech Republic analysed consequences of failures in strategic IT management at the state level. Lack of coordination and implementation rules reduced practical role of the ministry whose task ... was to guard high quality standards for all crucial IT systems in the state administration. Next consecquences were (among others) risk of uneconomical results of large IT investment and risk of inefficient
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Supreme Audit Office of Czech Republic
, issued in 2015
Risk cases: 7
Digital transformation in government
Support exemplars, provide consistent guidance... and do not lose focus As the NAO states: Government faces significant challenges in providing public services. While many government services are now available online, public administration is struggling to manage more complicated programmes and to improve the complex systems and processes that support public services.
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Support exemplars, provide consistent guidance... and do not lose focus As the NAO states: Government faces significant challenges in providing public services. While many government services are now available online, public administration is struggling to manage more complicated programmes and to improve the complex systems and processes that support public services.
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National Audit Office
, issued in 2017
Risk cases: 4
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
Electronic Health Records - VA Needs to Identify and Report Existing System Costs
Difficulties after 30 years of decentralized development The US Department of Veterans Affairs provides health care services to approximately 9 million veterans and their families. However, the IT system they use is more than 30 years old, is costly to maintain, and does not fully support exchanging health data. The US GAO, analyzed the system's modenization plans and found serious problems with definition and cost estimation.
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Difficulties after 30 years of decentralized development The US Department of Veterans Affairs provides health care services to approximately 9 million veterans and their families. However, the IT system they use is more than 30 years old, is costly to maintain, and does not fully support exchanging health data. The US GAO, analyzed the system's modenization plans and found serious problems with definition and cost estimation.
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US Government Accountability Office
, issued in 2019
Risk cases: 3
Coordination of Infrastructure Works by Metropolitan Municipalities
Rapid population growth at metropoles as well as dense and planless structuring, especially in İstanbul and Ankara, have lead to an increase in demand for utilities services and consequently ... in coordination of infrastructure services at MMs and preventing resource waste. ... , in the resources used for the construction and maintenance of utilities. Moreover, in cities with dense population, damages to roads and sidewalks during the construction and maintenance of utilities cause problems ... ... ... Start geographic information system with cooperation rules and digital maps ... Organization of geographic and infrastructure information systems is an especially difficult task when bacause vast and intense coordination is necessary. The Turkisch Court of Accounts lists ... problems that reduce use and rise costs of this fundamental task.
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Rapid population growth at metropoles as well as dense and planless structuring, especially in İstanbul and Ankara, have lead to an increase in demand for utilities services and consequently ... in coordination of infrastructure services at MMs and preventing resource waste. ... , in the resources used for the construction and maintenance of utilities. Moreover, in cities with dense population, damages to roads and sidewalks during the construction and maintenance of utilities cause problems ... ... ... Start geographic information system with cooperation rules and digital maps ... Organization of geographic and infrastructure information systems is an especially difficult task when bacause vast and intense coordination is necessary. The Turkisch Court of Accounts lists ... problems that reduce use and rise costs of this fundamental task.
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Turkish Court of Accounts
, issued in 2008
Risk cases: 2
Has Public Administration Used All Opportunities for Efficient Management of ICT Infrastructure?
Efficient Management of ICT Infrastructure Centralised management of ICT services and infrastructure would allow the institutions to optimise in long run their resources – financial, human, material and technical. However, we observed during the audit that the move towards ICT centralisation and single data centres has ceased. The different ministries and even the institutions subordinated to the same ministry do not cooperate sufficiently with each other regarding the ICT management, maintenance, and infrastructure placement. They rather choose to maintain their own, sometimes even several, data centres.
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Efficient Management of ICT Infrastructure Centralised management of ICT services and infrastructure would allow the institutions to optimise in long run their resources – financial, human, material and technical. However, we observed during the audit that the move towards ICT centralisation and single data centres has ceased. The different ministries and even the institutions subordinated to the same ministry do not cooperate sufficiently with each other regarding the ICT management, maintenance, and infrastructure placement. They rather choose to maintain their own, sometimes even several, data centres.
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State Audit Office of the Republic of Latvia
, issued in 2019
Risk cases: 3
Central government staff costs
Results of staff reductions The British NAO found that departments had significantly reduced numbers of their civil servants and of course salary costs at the same time. But they reduced staff numbers mainly by minimising recruitment, and the age profile of the civil service has changed. NAO pays a lot attention to what effect this has had on the future pipeline of talent and skills. It reminds also that the departments need long-term operating models to work efficiently with the staff reduced.
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Results of staff reductions The British NAO found that departments had significantly reduced numbers of their civil servants and of course salary costs at the same time. But they reduced staff numbers mainly by minimising recruitment, and the age profile of the civil service has changed. NAO pays a lot attention to what effect this has had on the future pipeline of talent and skills. It reminds also that the departments need long-term operating models to work efficiently with the staff reduced.
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National Audit Office
, issued in 2015
Risk cases: 5
Analysis of Trends in SAI Japan’s Findings
Analysis of IT audit cases by Board of Audit of Japan in years 2004-12. ... Not used IT systems and overpaid 'ghost' services ... Wrap-up of almost a decade of SAI of Japan's IT related audits results in a form of list of most often found problems. On the top of the list are unwanted or overpaid IT systems and too expensive ... maintanance. It makes you thinking: if one of the world technology leaders could find this, what could we find in our country...
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Analysis of IT audit cases by Board of Audit of Japan in years 2004-12. ... Not used IT systems and overpaid 'ghost' services ... Wrap-up of almost a decade of SAI of Japan's IT related audits results in a form of list of most often found problems. On the top of the list are unwanted or overpaid IT systems and too expensive ... maintanance. It makes you thinking: if one of the world technology leaders could find this, what could we find in our country...
Full description
Board of Audit of Japan
, issued in 2014
Risk cases: 3