HCFA should consolidate and simplify its decision processes to respond quickly and correctly to the rapidly changing health care environment. Regional Office Administrators and HCFA Center Directors report directly to the HCFA Administrator with no direct authority on the part of the Centers to require consistent implementation of Central Office policies in the Regions. HCFA should establish communication procedures to ensure that the Agency and its regional offices speak with one voice. I have mentioned only a few. However, I would be remiss if in addition to the administrative issues I have described, I didn't address the issue of payment.
Adequate payment is critical in order to attract health plans.