Available Information on Federal Spending, Cost Savings, and International Comparisons Has Limitations
December 6, 2012
The Departments of Health and Human Services (HHS), Veterans Affairs (VA), and Defense (DOD) administer programs that include preventive health activities such as health screenings and education campaigns, but the departments reported that they do not track department-wide spending on these activities. Departments reported that determining such spending is challenging because these activities can be integrated with other health activities. For fiscal year 2011, the departments provided to GAO a mix of information related to spending for preventive health activities, and noted limitations. These limitations included incomplete estimates, estimates that included activities that were prevention-related but not specifically for clinical preventive services or community-oriented preventive health activities, and estimates that represented funding--not spending--information. Funding estimates represent amounts available to the departments at a particular time, but not necessarily actual spending. For fiscal year 2011, HHS combined estimates of spending for prevention for one agency with estimates of funding for nine other HHS agencies for a total of about $24 billion; however, the estimate did not include the Centers for Medicare & Medicaid Services, which oversees health coverage programs for over 100 million individuals. VA and DOD estimated that, for example, fiscal year 2011 spending for clinical preventive services was about $576 million and $1 billion, respectively.