Department of Health and Human Services

This testimony highlights three challenges that the Department of Health and Human Services (HHS) faces in meeting its mission. First, HHS needs to better define its mission, objectives, and measures of success and increase its accountability to taxpayers. The Government Performance and Results Act presents HHS with opportunities to bring discipline to management at all levels of the Department, define the kinds of information needed to implement and assess its programs, and identify ways to progress toward accomplishing its goals. However, meeting the law's requirements for strategic plans, performance measures, and reporting on program accomplishments will not be easy. Second, HHS needs to ensure that it has the information systems necessary to manage and evaluate its programs and to track its progress in meeting performance goals. Third, HHS must constantly combat fraud, waste, abuse, and mismanagement. Medicare, for example, which accounts for more than half of HHS' total budget, is particularly vulnerable. HHS needs to be vigilant because its programs will likely continue to be targets to fraud and abuse and because waste and mismanagement can have serious consequences for both taxpayers and program beneficiaries.

GAO noted that: (1) the first challenge HHS faces is its ability to define its mission, objectives, and measures of success and increase its accountability to taxpayers; (2) because of the size and scope of its mission and the resulting organizational complexity, managing and coordinating HHS' programs so that the public gets the best possible results are especially difficult; (3) the Department has eleven operating divisions responsible for more than 300 diverse programs; (4) HHS has not always succeeded in managing the wide range of activities its agencies carry out or fixing accountability for meeting the goals of its mission; (5) another complicating factor is that HHS needs to work with the governments of the 50 states and the District of Columbia to implement its programs, in addition to thousands of private-sector grantees; (6) developing better ways of managing is essential if HHS is to meet its goals; (7) the 1993 Government Performance and Results Act (GPRA) presents HHS with opportunities to bring discipline to management of all levels of the Department, define the types of information it needs to implement and assess its programs, and identify ways to progress toward accomplishing its goals; (8) GPRA also poses a challenge to HHS, however, because meeting the law's requirements to prepare strategic plans, design performance measures, and assess and report on program accomplishments will not be an easy task; (9) similarly, HHS has found it difficult to develop the financial information necessary to permit an audit of its financial statements; (10) the second challenge confronting HHS is ensuring that it has the information systems it needs to manage and evaluate its programs and to track its progress in meeting performance goals; (11) managers must have reliable information both to implement their programs in a way that best serves the public and to assure the American people that federal programs are performing responsibly and well; (12) this is especially challenging for the Department because it relies so much on contractors, grantees, and state and local governments as its information partners; (13) finally, HHS responsibilities require it to constantly combat fraud, waste, abuse, and mismanagement; (14) HHS has several programs that are vulnerable to such exploitation; and (15) HHS needs to be vigilant now and in the future because its programs will probably continue to be the targets of fraud and abuse and because waste and mismanagement can have such serious effects on taxpayers and program beneficiaries.