HCFA: WORKING ON RESTRUCTURING PLANS, VLADECK MAY LEAVE
The Health Care Financing Administration (HCFA) is creatingThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
a "consumer unit" to better serve Medicare and Medicaid patients
as part of a "major agency-wide reorganization," WASHINGTON POST
reports. Health and Human Services Secretary Donna Shalala said
the restructuring will help HCFA "adapt to changes in the health
care market and to provide consumers in both health maintenance
organizations and fee-for-service plans the best quality and
information." The agency has been preparing its reorganization
plans for eight months, and the changes will not likely affect
numbers or locations of jobs, POST reports.
RESHUFFLING: Currently, HCFA's "patient operations" are
divided into three divisions: fee-for-service Medicare; Medicare
HMOs or other managed care; and Medicaid operations. When the
restructuring plan takes effect July 1, 1997, it would "largely
break up this 'vertical' structure and create a 'horizontal'
structure" with three units: Beneficiary Services and
Operations, Health Plan and Provider Operations, and State
Operations.
CONSUMERS: The beneficiary division, or consumer unit,
would treat all patients that fall under HCFA's jurisdiction as a
"customer group" with common concerns. The unit "would try to
determine the needs and problems of patients in all types of
medical coverage provided through HCFA." HCFA Administrator
Bruce Vladeck said, "For the first time, HCFA will have a
division explicitly dedicated to understanding and meeting the
needs of beneficiaries." The consumer unit would also conduct
surveys to keep services efficient and up-to-date and help solve
problems enrolling in Medicare, getting bills paid, receiving
reimbursements, finding doctors and filing appeals," POST
reports.
PROVIDERS: The plan and providers division would deal with
every provider "from whom Medicare purchases health services,
whether an HMO, a hospital, doctor, nursing home or home health
agency." The agency's business operations would be run in this
unit, including any interactions with "hybrid forms of service
delivery that might evolve in the future" or with bulk purchasing
arrangements.
AND STATES: The state division would handle "all contact
with the states involving Medicaid, as well as other state issues
that might have been handled separately now, such as monitoring
state inspection of health facilities and any insurance
regulation HCFA may be assigned" (Rich, 11/12).
HOMEWARD BOUND?: MEDICINE & HEALTH reports that Vladeck
"has let it be known that he falls into that category of New
Yorker that regards Washington as alien terrain inhospitable to
long term human life." However, Vladeck has reportedly said that
"if asked he'll stay 'at least for while.'" He said, "I think it
would be sort of unsportsmanlike to announce a major
reorganization and then split." MEDICINE & HEALTH reports that
the HCFA reorganization has left the role of Bruce Fried, head of
the Office of Managed Care, uncertain. The role of Fried and
other HCFA executives who were impacted by the reorganization
isn't expected to be announced "for a week or two." Phillip Lee,
assistant secretary for health, is expected to return to
California early next year; "sources say serious consideration is
being given to naming a single person who will hold both his job
and that of Surgeon General too." MEDICINE & HEALTH reports that
"current indications are that" Shalala "will keep her post"
(11/11 issue).