Smarter Government: Fixing Consolidation, Modernizing Healthcare, and Transforming Procurement

Original Broadcast 3/16/25

Presented by Maximus

On this edition of Fed Gov Today with Francis Rose, we examine three major areas shaping the future of federal operations. First, we explore the push for agency consolidation and how to ensure it improves efficiency without compromising mission effectiveness. Then, we shift to healthcare, as the Department of Veterans Affairs embarks on a large-scale modernization effort to enhance care through technology and data-driven insights. Finally, we dive into the persistent inefficiencies in federal procurement, where agencies continue to waste money on redundant software purchases despite available strategies for smarter spending.

Avoiding the 'Doom Loop' in Agency Consolidation

As the federal government considers consolidating agencies, Chris Mihm, former Director of Management Issues at the Government Accountability Office (GAO), warns against treating consolidation solely as a budget-cutting exercise. Instead, he stresses that successful efforts require a broader reform strategy that enhances effectiveness, fosters a culture of informed risk, and ensures that agencies work seamlessly across organizational boundaries.

Loren DeJonge Schulman, former Associate Director for Performance at the Office of Management and Budget (OMB) and now principal at Telos Lab, reinforces the importance of strong leadership in these transitions. She emphasizes that having a dedicated implementation team is critical to sustaining long-term reforms, rather than letting them stall after initial announcements. Additionally, Schulman highlights the need to maintain a human-centered approach, ensuring that public servants affected by these changes receive support and clear communication.

Both Mihm and Schulman stress that without proper stakeholder engagement and a clear vision for mission continuity, consolidation efforts risk becoming an ineffective “doom loop” rather than a pathway to efficiency.

Key Takeaways:

• Reform Must Be More Than Just Cost-Cutting – Agency consolidation should be about improving effectiveness, not just downsizing.
• Strong Leadership & Implementation Teams Are Critical – Without a dedicated team overseeing execution, reforms often fail to materialize.
• Stakeholder Engagement Ensures Success – Effective communication with employees and external partners prevents disruptions to public services.

The Healthcare Drive for Efficiency and Effectiveness

Monica Rosser, Executive Managing Director for Federal Health at Maximus, joined Fed Gov Today with Francis Rose to discuss the critical components of this transformation. She emphasized that while new technologies such as artificial intelligence (AI), machine learning (ML), and robotic process automation (RPA) are at the forefront of modernization, successful implementation depends on understanding the needs of both healthcare providers and patients.

Rosser highlights the increasing role of artificial intelligence, machine learning, and robotic process automation in federal healthcare. However, she cautions that these tools must be carefully aligned with user needs to ensure they enhance, rather than complicate, service delivery. She also underscores the importance of human-centered design, advocating for a holistic approach that integrates both provider workflows and patient experiences into modernization strategies.

Beyond technology, Rosser raises an often-overlooked issue: the growing demand for caregiver support in military and veteran communities. With an aging population and millions of caregivers providing critical assistance, she calls for greater policy focus and interagency collaboration to ensure these individuals receive the resources and interoperability they need.

Key Takeaways:

• AI & Automation Must Be Integrated Thoughtfully – Emerging technologies should enhance care delivery, not create additional complexity.
• Human-Centered Design is Key – Modernization efforts must consider both patient experience and provider needs.
• Caregiver Support Needs More Attention – With an aging veteran population, federal agencies must prioritize policies that support caregivers.

Building Better Buying Power in Federal Procurement

Despite repeated efforts to improve procurement efficiency, the federal government still struggles with wasteful purchasing habits. Joe Jordan, former Administrator of Federal Procurement Policy at OMB and now CEO of Actupara, points out that agencies often buy thousands of unnecessary software licenses, wasting taxpayer dollars. He argues that greater use of enterprise-wide buying strategies could significantly reduce costs, but bureaucratic resistance and concerns over budget flexibility continue to slow progress.

Jordan recalls efforts like the Federal Strategic Sourcing Initiative and category management, which aimed to drive smarter purchasing. He explains that for real change to happen, senior leadership must enforce enterprise procurement policies, and agencies need assurances that they won’t permanently lose funds if they reduce spending in one area. Additionally, Jordan stresses the importance of data transparency, calling for improved visibility into pricing so agencies can make more informed decisions.

With reports suggesting that the Trump administration may push all federal purchasing through the General Services Administration (GSA), Jordan sees this as a potential “stick” to force compliance. However, he cautions that any centralization effort must be well-structured to avoid unintended consequences.

Key Takeaways:

1. Enterprise Procurement Reduces Waste – Agencies should adopt government-wide purchasing agreements to cut costs.
2. Pricing Transparency is Critical – Improved data-sharing across agencies would drive smarter procurement decisions.
3. Leadership Must Drive Change – Without senior-level enforcement, agencies will continue to resist enterprise-wide buying strategies.