Most disturbing, however, has been the erosion of trust and respect between the agency and those that it serves. This year's reform debate holds the possibility of fostering a constructive dialogue on how to improve the agency's performance. The key to any reform effort is focusing on the root causes of performance problems, designing workable solutions, matching resources to the required work, and building in accountability measures.
However, if the result of all this attention is merely a reorganization or a few changes in operating procedures, the effort will likely be more harmful than helpful. An agency staff of approximately provides policy and operations support in Baltimore and 10 regional offices across the country. In partnership with the states and private entities, CMS provides oversight of the health care system by conducting inspections at thousands of hospitals, nursing facilities, home health agencies, laboratories, and hospices.
The agency was completely reorganized in with the goal of enhancing its focus on beneficiaries and integrating its policy and operational activities. As a result, most of the work in the agency now requires collaboration of staff across components of the organization. All these responsibilities and relationships would be difficult to manage under the best of circumstances. Certainly CMS's current circumstances are not ideal. The agency's discretion has been severely circumscribed by ever more prescriptive legislation eroding much of its capacity to fix unexpected problems.
Failures to coordinate the work of regional offices and contractors and to hold them accountable for consistent implementation of policy are a source of great irritation to providers and health plans. As a result, a continuing drumbeat of criticism by providers and many in Congress has all but drowned out any dispassionate appraisal of the agency or serious discussion of what it will take to improve performance.
Considerations for Reform The most important ingredient in a CMS reform strategy is to change the tone and the content of the debate. All the stakeholders need to focus on a common vision for how CMS should look and function. The hostility and mistrust that characterize the relationships of CMS, providers, and congressional leaders need to be set aside before an honest conversation about problems and solutions can be held.
Four priority areas should be addressed in any reform strategy:. The programs administered by CMS provide health coverage for one fourth of all Americans. We have an obligation to ensure that the promise of these programs is a reality for today's beneficiaries and those to come. We distribute our journalism for free and without advertising through media partners of all sizes and in communities large and small.
We appreciate all forms of engagement from our readers and listeners, and welcome your support. Thank you! Thursday, Jun 11 Expanding the agency's Medicare information line, MEDICARE, to a hours-a-day, seven-days-a-week "service that will provide far more detailed information to help beneficiaries make Medicare decisions.
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Alternatives to Medicaid Medicare's coverage of nursing home care is quite limited.
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