Results Act

Pursuant to a congressional request, GAO provided information on the Department of Health and Human Services' (HHS) performance plan to address medical research, focusing on whether the performance plan: (1) provided objective and measurable performance goals by which the outcomes of medical research programs could be assessed; (2) described strategies for achieving the specified research goals; (3) identified factors that could affect the ability to achieve the research goals and provided an indication of how these factors would be addressed; and (4) indicated how different research agencies within HHS would coordinate their efforts to achieve the research goals.

GAO noted that: (1) the agencies did not always identify measurable outcomes that would allow an assessment of their research accomplishments; (2) in some cases, their objective was to increase understanding or create new knowledge without a specific application in mind; (3) in some instances, when the objective was directed toward obtaining knowledge to meet specific needs, the agencies were able to specify measurable outcome-oriented goals; (4) however, even where the research was directed toward a specific need, the goals were not always specific in a measurable form; (5) generally the agencies did not explicitly identify their strategies for accomplishing their specific research goals; (6) however, the performance indicators included in the plan as a means of assessing progress toward achieving their goals provided some insight as to what those strategies might be; (7) although not required under the Government Performance and Results Act, the usefulness of the performance plan would be enhanced by a discussion of major factors outside the control of the agency that could affect the agency's ability to achieve its goals; (8) two important factors that the agencies have limited control over are the inherently unpredictable nature of research and research conducted externally by grantees rather than by agency personnel; (9) none of the agencies specifically discussed in the plan how these two factors might affect their ability to accomplish their goals or how they would account for them; (10) in describing the goals, performance indicators, and strategies for achieving the goals, the plan gave the impression that research would achieve the desired outcomes; (11) there was no acknowledgment of the possibility of not accomplishing the goals because of the risks associated with research and there was no discussion of how the agencies intend to mitigate the risks; (12) when research is conducted externally by research grantees, the agency has less control over activities throughout the course of the research that can affect the outcomes; (13) although the agency can influence the research outcomes through the priorities it sets for its research agenda, the grants it awards, and the monitoring of research activities, there was no discussion in the plan linking such activities to the attainment of its goals; and (14) as the process of strategic planning, annual goal setting, and performance reporting proceeds under the Results Act, GAO expects HHS' performance plan to become more specific about what the department intends to accomplish and how the various HHS agencies will achieve their intended research goals.