Transformation

Four reports out this week highlight the potential consequences of not investing in the nation’s infrastructure and how states can make better use of existing resources to improve transportation. Our friends at the American Society of Civil Engineers (ASCE) are out with the fourth installment in their “Failure to Act” series, which examines the economic cost of current infrastructure investment trends. The Bipartisan Policy Center and Eno Center for Transportation examine what a reduced federal investment could mean for transportation (and for state and local governments). A report from the Brookings Institution and Rockefeller Foundation outlines ways states can enhance the impact of state infrastructure banks and revolving funds for transportation. And best practices for state departments of transportation are the focus of a new report from Smart Growth America and the State Smart Transportation Initiative.

The numbers are eye opening. The Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees Medicaid, estimates that improper payments in the Medicaid program totaled $21.9 billion in fiscal year 2011. And the national payment error rate (called the “PERM” rate)[1] for Medicaid was 8.1 percent in the same year. Although these figures are reported annually, they are receiving even more attention this year than usual. That’s in part due to the stress that federal and state governments are under to trim budgets and increase the efficiency of programs, but also because, for the first time, CMS has released state-by-state breakdowns of individual state error rates. 

Earlier this month, the U.S. Government Accountability Office (GAO) released its first annual report to Congress in response to a new statutory requirement that the department identify federal programs, agencies, offices, and initiatives, either within departments or government-wide, which have duplicative goals or activities.

As states face growing budget gaps and policymakers are forced to make tough choices to balance budgets, several states have also established commissions to evaluate the operational and outcome efficiencies of state government and to develop recommendations for improvement. Here is a preliminary list of those commissions and their findings: