sioner of the Food and Drug Administration (FDA)—which would provide critical continuity in the nation’s public health and scientific endeavors.

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.

The secretary should ensure that all department health programs, including the reimbursement programs, reinforce public health priorities and strategies in order to provide a consistent framework for protecting the public from health risks, promoting health, preventing disease and disability, and providing health services for vulnerable populations in the most efficient, cost-effective ways.

To maximize value in the health care system, the secretary must strengthen the scientific base and capabilities of the department and ensure that agencies’ research findings are shared department-wide and that current best evidence is used for departmental decision making, including the Centers for Medicare and Medicaid Services (CMS) reimbursement policy.

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.

To address the growing threat of food-borne illnesses, Congress should unify the U.S. Department of Agriculture’s (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.

The secretary should accelerate the establishment of a collaborative, robust system for evaluating the health care system that would incorporate existing department and external research, stimulate new studies as needed, synthesize findings, and provide actionable feedback for policy makers, purchasers, payers, providers, health care professionals, and the public.

1. 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

2. 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.

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