results; in return, Congress should allow the department greater flexibility in its internal operations and decision making.

  1. To enable greater accountability, the secretary should oversee development and implementation of a department-wide data, evaluation, and information system. The system should be based on a broad analytic framework designed to aid in managing departmental operations, learning from program experience, evaluating the costs and impact of programs, and determining whether they provide sufficient value for the investment of public funds.

  2. Congress should authorize the secretary to direct funding from the budgets of all departmental units to support the development of an HHS-wide information system. Funding for such a system would benefit all department units.

  3. The department should use the data, evaluation, and information system to

    • enable the secretary to provide Congress with regular reports on progress toward achieving departmental goals,

    • inform policy development,

    • facilitate cross-department activities,

    • provide operational information to program management for quality improvement and midcourse corrections, and

    • support effective long-range planning.

  1. For those outside the department, the system should

    • be accessible, transparent, timely, and reliable, and

    • provide useful, privacy-protected information regarding department activities.

  1. The department should demonstrate accountability through continuous critical assessment of program efficiency, equity, impact on health, and cost-effectiveness, and through corrective action for underperforming programs.

  2. The secretary, in collaboration with the surgeon general, should present Congress and the public with an annual “State of the Nation’s Health” report that describes progress toward achieving the vision for the nation’s health and the department’s key health goals.

  3. Congress should establish a new, strategic initiative fund to enable the secretary to support cross-agency and cross-departmental activities that exhibit innovation in responding to twenty-first century challenges, and to respond quickly to new, unforeseen, or expanding public health threats.


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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