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HHS in the 21st Century: Charting a New Course for a Healthier America
The secretary should work with Congress to ensure that the department’sprograms and reimbursement policies are outcomes-based, reflectingbest available evidence of value and creating incentives for adoption of best practices, includingintegration of care, in order to improve qualityand efficiency.
The department shouldcollaborate with state andlocal public health agencies and community-basedorganizations, as both sources and users of practical program guidance.
The department should provideauthoritative,plain-language, and current evidence-based informationto the public regarding prevention andtreatment options.
To assess the health of the American people andoverall health system performance accurately, thedepartment needs current data from the nation’shealth system. To facilitate collection of thesedata, the department should actively promote theuniversal adoption ofelectronic information capabilities—including health information exchangeand electronic medical, personal health records—for administrative and clinical purposes.
HHS’S ROLE IN A VALUE-BASED SYSTEM
Medicare and Medicaid exert powerful influence on the U.S. health care system beyond the impact of the large dollars they expend. Because their rules and coverage decisions often are adopted by private payers, these two public programs—although limited to covering specific population groups—affect the entire health care system and all Americans. Also, some of their reimbursement strategies—especially those supporting traditional fee-for-service care—have inadvertently contributed to the rapid growth in health care costs. As the Institute of Medicine (IOM) committee considered its charge to examine how the Department of Health and Human Services (HHS) could be more effective in “advanc-
dissenting opinions, which can be found in Appendix F. They were unable to agree on a common statement.