these officials—especially the directors of the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), and the commissioner of the Food and Drug Administration (FDA)—which would provide critical continuity in the nation’s public health and scientific endeavors.

2e. The President should make timely appointments and Congress should expedite the confirmation process for key HHS officials, including the secretary, deputy secretary, surgeon general, and the heads of FDA and NIH. Secretarial appointments, such as the director of CDC, should also be expedited.

2h. Congress should allocate sufficient, predictable funding for NIH, CDC, FDA, and AHRQ in order to preserve and enhance these agencies’ scientific missions. Congress should also establish a specific budget line for AHRQ that is independent of appropriations to other HHS agencies.

2i. To address the growing threat of food-borne illnesses, Congress should unify the USDA’s Food Safety and Inspection Service and the food safety activities of FDA within HHS and ensure provision of adequate resources for high-quality inspection, enforcement, and research.

Recommendation 3:

Increase Effectiveness and Efficiency of the U.S. Health Care System

3a. The secretary should work with Congress to establish a capability for assessing the comparative value—including clinical and cost-effectiveness–of medical interventions and procedures, preventive and treatment technologies, and methods of organizing and delivering care. The assessment of comparative value should begin by leveraging department-wide data sources in conjunction with supportive evidence from providers, payers, and health researchers.a

3b. The secretary should work with Congress to ensure that the department’s programs and reimbursement 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.


aThe committee did not reach consensus on recommendation 3a. Although the majority of the committee supports the language of the recommendation, David Beier, J.D., Senior Vice President of Global Government and Corporate Affairs, Amgen; Kathleen Buto, M.P.A., Vice President, Health Policy, Johnson & Johnson; and Myrl Weinberg, C.A.E., President, National Health Council, did not agree with the majority’s view and provided dissenting opinions, which can be found in Appendix F. They were not able to agree on a common statement.

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