	Congress and Executive Branch Agencies Continue to Address Actions That Span the Federal Government

We monitor the progress that Congress and executive branch agencies  have made in addressing the issues we identified in each of our last  seven annual reports. As of March 2018, 376 (52  percent) of the actions we identified from 2011 to 2017 have been fully  addressed. Billions in Financial Benefits Due to Actions Taken by Congress and Executive Branch Agencies

The progress Congress and executive branch agencies have made in  addressing our open actions has resulted in $178 billion in financial  benefits, including roughly $125 billion in financial benefits from 2010  through 2017, with at least an additional $53 billion in estimated benefits  projected to accrue in 2018 or later. Table 5 highlights examples of  these results. We anticipate that CMS’s recent actions  could potentially reduce the federal government’s liability for Medicaid by  billions, or tens of billions, annually. For over two  decades, we and others have reported on problems caused by  fragmented leadership and a lack of a single authority in oversight of  these multibillion dollar programs. Separately, in the National Defense  Authorization Act for Fiscal Year 2018, Congress made changes to  certain DOD space leadership positions and required the department to  conduct a review and identify a recommended organizational and  management structure for its national security space components, and  submit related reports. Action on Remaining and New Areas Could Yield Significant Additional Benefits

While Congress and executive branch agencies have made progress  toward addressing the 798 total actions we have identified since 2011,  further steps are needed to fully address the 365 actions that are partially  addressed or not addressed. We estimate that tens of billions of dollars  in additional financial benefits could be realized should Congress and  executive branch agencies fully address open actions. Significant Open Actions Directed to Congress

Congress has used our work to identify legislative solutions to achieve  cost savings, address emerging problems, and find efficiencies in federal  agencies and programs. Our work has contributed to a number of key  authorizations and appropriations. In our 2011 to 2018 annual reports, we directed 100 actions to Congress,  including the 3 new congressional actions we identified in 2018. Advancing the Implementation of Government-Wide Policies and Performance

Many of the results the federal government seeks to achieve require the  coordinated effort of more than one federal agency, level of government,  or sector. In our 2011 to 2018 reports, we directed 66 actions to OMB in areas to  improve the efficiency and effectiveness of government-wide programs  and activities. Improving Support and Services for Veterans

In our 2011 to 2018 reports, we directed 54 actions to the Department of  Veterans Affairs (VA) in areas that contribute to VA effectively and  efficiently achieving its mission to promote the health, welfare, and dignity  of all veterans by ensuring that they receive medical care, benefits, and  social support. We will continue to look for additional or emerging instances of  fragmentation, overlap, and duplication and opportunities for cost savings  or revenue enhancement. Contact  points for the individual areas listed in our 2018 annual report can be  found at the end of each area in GAO-18-371SP.
Why GAO Did This Study

The federal government faces a long- term, unsustainable fiscal path based on an imbalance between federal revenues and spending. While addressing this imbalance will require fiscal policy changes, in the near term opportunities exist in a number of areas to improve this situation, including where federal programs or activities are fragmented, overlapping, or duplicative.
To call attention to these opportunities, Congress included a provision in statute for GAO to identify and report on federal programs, agencies, offices, and initiatives—either within departments or government-wide—that have duplicative goals or activities.
GAO also identifies areas that are fragmented or overlapping and additional opportunities to achieve cost savings or enhance revenue collection. GAO's 2018 annual report is its eighth in this series ( GAO-18-371SP ).
This statement discusses
new areas identified in GAO's 2018 annual report;
the progress made in addressing actions GAO identified in its 2011 to 2017 reports; and
examples of open actions directed to Congress or executive branch agencies.
To identify what actions exist to address these issues, GAO reviewed and updated prior work, including recommendations for executive action and matters for congressional consideration.

What GAO Found

GAO's 2018 annual report identifies 68 new actions that Congress or executive branch agencies can take to improve the efficiency and effectiveness of government in 23 new program areas. For example:
The Department of Defense (DOD) could potentially save approximately
$527 million over 5 years by minimizing unnecessary overlap and duplication in its U.S. distribution centers for troop support goods.
The Department of Energy may be able to reduce certain risks and save tens of billions of dollars by adopting alternative approaches to treat a portion of its low-activity radioactive waste at its Hanford Site.
The Department of Veterans Affairs could potentially save tens of millions of dollars when acquiring medical and surgical supplies by better adhering to supply chain practices of leading hospitals.
The Coast Guard should close its boat stations that provide unnecessarily duplicative search and rescue coverage to improve operations and potentially save millions of dollars .
Significant progress has been made in addressing many of the 724 actions that GAO identified from 2011 to 2017. As of March 2018, Congress and executive branch agencies have fully or partially addressed 551 (76 percent) of these actions. This has resulted in about $178 billion in financial benefits, of which $125 billion has been realized and at least an additional $53 billion is estimated to accrue. These estimates are based on a variety of sources that considered different time periods, assumptions, and methodologies. GAO estimates that tens of billions of additional dollars could be saved should Congress and executive branch agencies fully address the remaining 365 open actions, including the 68 new ones identified in 2018.
Further steps are needed to fully address these remaining actions. For example:
Congress and the Internal Revenue Service could realize hundreds of millions of dollars in savings and increased revenues by enhancing online services and improving efforts to prevent identity theft refund fraud.
Medicare could save $1 to 2 billion annually if Congress equalized the rates paid for certain health care services, which often vary depending on where the service is performed.
DOD could achieve billions of dollars in savings over the next several years by continuing to employ best management practices on its weapon systems acquisition programs.
Congress could consider modifying how Medicare pays certain cancer hospitals to achieve almost $500 million annually in program savings.
The Social Security Administration could help prevent the loss of billions of dollars by preventing overpayments to beneficiaries of the Disability Insurance program and improper waivers of beneficiaries' overpayment debt.
Congress could consider modifying tobacco tax rates to eliminate significant tax differentials between similar products to address future revenue losses caused by manufacturers and consumers substituting tobacco products. Federal losses ranged from $2.6 to 3.7 billion between April 2009 and February 2014.