HCFA and the National Partnership for Reinventing
The National Partnership for Reinventing Government (NPR) is a
Clinton Administration initiative, under the leadership of Vice
President Gore. NPR is designed to "reinvent" or "reengineer" the
Federal bureaucracy to provide better service to the American public
and more efficient use of taxpayer dollars.
HCFA was designated one of 32 Federal agencies that has a
particularly direct impact on the American public. Originally called
reinvention impact centers and later named high impact agencies,
these agencies are expected to move toward being fully reengineered
according to the NPR principles over the next several years.
As a high impact agency, HCFA is committed to the following
In partnership with others, HCFA works to improve health
outcomes, including reducing the incidence of disease and the number
of preventable deaths. As an NPR high impact agency, HCFA has
committed to improve the well being and survival of Medicare and
Medicaid beneficiaries through increased use of preventive services
and other means. Specific performance targets have been established
in the following areas:
- Increase the percentage of States (from 34 percent to 100
percent) conducting maternal AIDS information projects. These
projects inform women of childbearing age of the importance of
prenatal HIV testing and treatment if necessary. They also explain
that these services are covered for Medicaid-eligible
STATUS: As of February 2000, 44 States
(88 percent), the District of Columbia and Puerto Rico were
conducting maternal AIDS education projects.
- Increase from 59 percent (1995) to 80 percent the number of
Medicare beneficiaries with end stage kidney disease receiving
STATUS: In 1998, the
percentage of Medicare beneficiaries with end stage kidney disease
who were receiving adequate dialysis had risen to 74 percent. The
1999 data will be available in Fall 2000.
- Decrease the one-year mortality rate among Medicare
beneficiaries hospitalized for a heart attack from 31 percent to
27 percent over 5 years. This is a decrease of 1 percentage point
more than the national trend.
data not yet available.
- Increase from 55 percent (1994) to 60 percent the number of
Medicare beneficiaries aged 65 and older receiving an influenza
vaccination (flu shot).
STATUS: We met our
target by achieving a 9 percent increase to 64 percent in 1998.
- Increase from 24.6 percent (1994) to 60 percent the number of
Medicare beneficiaries age 65 and over receiving a vaccination for
pneumonia. We projected that 50 percent of Medicare beneficiaries
would be vaccinated by 2000 and 60 percent by
STATUS: According to 1998 data, 56
percent of persons age 65 and older received a lifetime
pneumococcal vaccination, surpassing our expectations for the year
- Increase from 55 percent (1994) to 60 percent the percentage
of female Medicare beneficiaries age 65 years and older receiving
a mammogram every two years.
STATUS: We met
our target by achieving an 8.8 percent increase to 63.8 percent in
Medicare Financial Integrity
HCFA is working to safeguard taxpayer dollars by improving the
financial integrity of the Medicare program. Efforts include a
stronger emphasis on reducing mistaken or inaccurate payments and
preventing fraud and abuse. As a high impact agency, HCFA is
specifically committed to the following goals:
- Achieve more than half of Medicare program integrity savings
by reducing mistaken or inaccurate payments made on a prepayment
basis. This means that more errors are detected and corrected
before payment is made, eliminating the need to "pay and
chase" overpaid amounts.
STATUS: This goal has
- Improve the efficiency of Medicare claim review by increasing
the number of claims medically reviewed by 10 percent above
original projections without increasing available funding. By more
efficient review of Medicare claims to make sure that services
being billed were medically necessary, we will detect and prevent
more fraud, waste and abuse in the Medicare
STATUS: Progress data not yet
HCFA had hoped to assess interventions to promote diabetic eye
exams as a measure of diabetes disease management as one of its NPR
goals. Due to limitations in data reporting for this measure, this
has proved to be an infeasible goal for NPR in the calendar year
2000. HCFA remains committed to improving diabetes management for
its beneficiaries. We work closely with our partners to promote
quality diabetes care and are developing a performance measure to
track this important issue.
For further information on HCFA's NPR goals, please contact Les
Horneman at (410) 786-1044.