bursement policies are outcomes based, reflecting best available evidence of value and creating incentives for adoption of best practices, including integration of care, in order to improve quality and efficiency.

  1. The department should collaborate with state and local public health agencies and community-based organizations, as both sources and users of practical program guidance.

  2. The department should provide authoritative, plain-language, and current evidence-based information to the public regarding prevention and treatment options.

  3. To assess the health of the American people and overall health system performance accurately, the department needs current data from the nation’s health system. To facilitate collection of these data, the department should actively promote the universal adoption of electronic information capabilities—including health information exchange and electronic medical, personal health records—for administrative and clinical purposes.


Analysts predict serious shortages of people with the right backgrounds, training, and skills in the department’s senior levels, in the nation’s health care workforce, in state and local public health agencies, and in the science establishment. These shortages can manifest themselves in the number, professional mix, geographic distribution, or composition of the workforces. The problems include

  • an aging workforce, nearing retirement, in HHS and state and local health departments, especially among experienced scientists, managers, and professionals;

  • a wide array of new health challenges that require strong new skills;

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