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HHS in the 21st Century: Charting a New Course for a Healthier America
Because these goals cover every current departmental program and activity, they are too broad to encourage focus. (The current secretary has established 10 other, somewhat narrower priorities3 that are not formally tracked and a 500-day plan for the department based on his core principles,4 both entirely separate from the department’s strategic plan.)
Under each of the four strategic plan goals, in turn, are four broad objectives. Progress toward these objectives is measured by benchmarks (called “performance indicators”) that have established targets and are reported in the annual plan and the annual performance and accountability report, additional requirements of GPRA. What is not clear from the strategic plan is the strategy for reaching the four goals (other than continuing to do what is already being done) and, consequently, whether or how the performance measures relate to strategy. The goals are essentially an endorsement of the status quo, not a recipe for meaningful change.
In a separate effort, the administration introduced the PART initiative in 2002,5 managed by the Office of Management and Budget, with results available on the Internet since 2006 (see http://www.ExpectMore.gov). Staff members of individual programs, in collaboration with Office of Management and Budget (OMB) staff, assess their program’s performance (see Box 6-1). The following are the collective PART ratings for the 115 department programs assessed to date:
Effective (scores of 85–100): 16% of HHS programs
Moderately effective (70–84): 32%
Adequate (50–69): 25%
Ineffective (1–49): 5%
Results not demonstrated: 22% (OMB, 2008c)
These priorities are: every American insured, insurance for children in need, value-driven health care, information technology, personalized health care, health diplomacy, prevention, Louisiana health care system, pandemic preparedness, and emergency response.
These principles are: care for the truly needy, foster self-reliance; national standards, neighborhood solutions; collaboration, not polarization; solutions transcend political boundaries; markets before mandates; protect privacy; science for facts, progress for priorities; reward results, not programs; change a heart, change a nation; and value life.
In 2005, the PART program received an “Innovations in American Government Award,” from the Kennedy School of Government (Harvard University), an award program administered in partnership with the Council for Excellence in Government. In April 2006, it received the Government Performance Management Excellence Award from the Performance Institute, a leading adviser to government on performance issues.