and should encourage Congress to invest in programs with proven effectiveness.

  1. Congress should give the secretary authority to create new programs that invest in the future generation of biomedical and health services researchers, enabling the continued discovery of new, more effective methods of preventing, treating, and curing disease; promoting health; improving health care delivery and organization; and controlling health system costs.


A strong system of accountability will provide information needed to improve HHS performance and will lead ultimately to better health for the American people. Accountability should begin with the development of measurable, time-specific goals3 and should include

  • clear lines of responsibility,

  • quantifiable targets and time-specific milestones,

  • strategies to overcome perceived barriers,

  • regular reporting and assessments,

  • a reward and recognition system that promotes achievement,

  • a clear understanding of progress, and

  • corrective action as needed.

To facilitate improved accountability, HHS needs a department-wide information system that would provide a panoramic view of how its health and human services programs work together to achieve departmental goals. Data supporting this system should come from within the department and from its key government partners. The information sys-


HHS currently operates under a complex web of internally and externally generated goal-setting and reporting requirements, which includes Healthy People 2010, the department’s five-year strategic plan, the Government Performance and Results Act, the Program Assessment Rating Tool, and the President’s Management Agenda. Hundreds of discrete data points must be documented to satisfy these requirements; yet true accountability is still lacking, because these reports are not used to guide strategies for improved performance or for funding decisions.

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