STRATEGIC PLAN - ASPE - U.S. Department of Health and Human ...

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Appendix a: program evaluation effortsProgram Assessment Rating ToolThe Program Assessment Rating Tool (PART) was createdto improve program performance and inform fundingand management decisions throughout the FederalGovernment. From CYs 2002–2006, HHS reviewednearly all programs using the PART. The review processinvolved with PART helps to identify each program’sstrengths and growth areas through a comprehensiveanalysis of the program’s purpose and design; performancemeasurement, evaluation, and strategic planning;program management; and program results.After a PART review, programs implement a series offollowup actions to improve program effectiveness.PART results may lead programs to develop new performanceindicators, conduct independent evaluationsof program activities, request legislative changes to theprogram structure, or make a series of other programimprovements. The Strategic Plan highlights severalmeasures developed during the PART process.Role of Program Evaluations inStrategic PlanningAs noted above, evaluations play an important role insetting the goals and objectives in strategic planning.Examples follow below.Strategic Goal 1: Health CareBy closely monitoring the implementation of the newMedicare prescription drug benefit and the capacity torespond to Medicare beneficiaries’ questions, HHS wasable to provide the resources needed to improve theability of beneficiaries, and the others who assist them,to obtain the information they needed to enroll in adrug plan. In addition, the demographic and other informationdeveloped to describe Medicaid beneficiariesand the uninsured are helping policymakers determinehow to address these issues.Success in increasing health care service and availabilityrelies, in part, on how effectively we are able toensure the successful translation of research into safeand effective medical products. Evaluation informationsupports our ability to help human drug sponsors improvethe quality of their drug development and relatednew drug applications. The Prescription Drug and UserFee Act of 1992 (Public Law 102-571), as amended (PD-UFA III), effective from FYs 2003–2007, expanded userfee funding to support several initiatives to improveapplication submissions and FDA-sponsored interactionsduring drug development and application review.FY 2005 was the fifth consecutive year in which FDAreceived an increased number of priority original drugapplications, which represent significant new medicaltreatments for American patients. Additionally, FDAfound that new mechanisms for FDA-sponsored interactions,such as meetings and consultations during thedrug development phase, had a positive impact on therate of first-cycle approval of drug applications, whichspeeds the availability of safe and effective new medicaltreatments to patients.Through the Medicaid program, a substantial numberof people receive personal assistance services, whichallow them to function independently in their ownhomes. Consumer-directed services further allow beneficiariesto manage not only their human assistance,but also other covered supportive services. Cash andCounseling is an expanded model of consumer-directedservices. ASPE and the Robert Wood Johnson Foundationcollaborated to fund the Cash and CounselingDemonstration Evaluation (CCDE) to track the experiencesof beneficiaries and providers in three States—Florida, Arkansas, and New Jersey—that participated ina unique Medicaid waiver experiment. Because of theCCDE, 11 other States have been selected to participatein an expansion of Cash and Counseling. Equally important,consumer choice, control, and empowermenthave been inculcated throughout the Medicaid programand are reflected in many of the long-term careinitiatives highlighted in this Strategic Plan, includingthe Money Follows the Person demonstration.Strategic Goal 2: Public HealthPromotion and Protection, DiseasePrevention, and EmergencyPreparednessThe development of food labeling information strategieswas based in part on information from the FDAHealth and Diet Survey – 2004 Supplement. Through thedata gained from this survey, we were able to identifythat most people have a limited understanding of mostdietary fats and their relationship to the risk of coronaryheart disease. In addition, we gained new informationon consumer attitudes toward diet, health, andphysical activity.As a part of a wide-ranging effort to improve patientsafety, in 2004 FDA finalized a rule requiring barcodeson the labels of thousands of human drugs and biologicalproducts. The measure is to protect patients frompreventable medication errors by helping ensure that140 HHS Strategic Plan FY 2007-2012
Appendix a: program evaluation effortshealth professionals give patients the right drugs at theappropriate doses. FDA estimates that the rule willhelp prevent nearly 500,000 adverse events and transfusionerrors while saving $93 billion in health care costsover 20 years.Obesity has reached epidemic levels and is a primaryfocus of many HHS public health interventions. However,little is known about the dynamics of how obesityaffects disability and other health outcomes as peopleage. To help inform policy and programmatic decisionsaround research and interventions aimed at preventingand treating obesity and alleviating its potentialeffects on disability and other health outcomes, ASPEis analyzing data from the Health and Retirement Surveyas well as the Assets and Health Dynamics Among theOldest Old Study. These data will expand our understandingof how obesity affects disability and otherhealth outcomes as people move from late adulthoodto older ages.Strategic Goal 3: Human ServicesThe National Evaluation of Welfare-to-Work Strategiesand the State welfare waiver evaluations foundthat mandatory welfare employment programs thatemployed a work-first approach are effective in increasingthe employment and earnings of welfare recipients,particularly long-term recipients. These findingshelped to influence the provisions of the Deficit ReductionAct of 2005 (Public Law 109-171) that strengthenthe TANF work requirements.Early findings from the Family and Child ExperiencesSurvey (FACES) showed that Head Start children werenot performing well in the area of letter identificationand vocabulary. These findings motivated Head Start’sintensive efforts to strengthen children’s preliteracy.According to more recent FACES data, Head Startchildren are coming closer to national norms for letterrecognition. The percentage of Head Start parentsreading to their children three or more times a weekhas also increased, after intensive efforts to improveearly literacy activities. Head Start anticipates continuedgains as it continues to focus training and technicalassistance resources in this area.ASPE conducted a study to assess the costs of providingsupportive services to individuals and families whoare experiencing homelessness and residing in thehomeless assistance programs through the U.S. Departmentof Housing and Urban Development (HUD). Thefindings identified the actual cost of these services andthe myriad funding streams used. The study findingshelped guide subsequent HHS and Administration policieson supportive services for individuals and familiesexperiencing homelessness, particularly those residingin HUD homeless assistance programs.Strategic Goal 4: Scientific Researchand DevelopmentAHRQ sponsored the Combining Clinical and AdministrativeHospital Data Evaluation project. AHRQ alsoidentified the most efficient set of clinical data elementsthat can be added to administrative data toincrease the reliability and validity of hospital-specificpublic quality reporting. The intent was to developmixed clinical-administrative data models that areclinically sound and defensible. The study focused onadding key clinical data elements to specific measuresfrom the AHRQ Quality Indicators (QIs) to create clinicallyenhanced QIs.Health information technology (health IT) is increasinglyviewed as a tool that can promote quality andcost-effective care in the United States. Althoughmuch progress has been made in the development ofelectronic health records and other infrastructure, thelack of robust evidence on health IT costs and benefitsacross settings has stymied efforts to develop suchcapabilities in the post-acute care (PAC) and long-termcare environment. A deeper, evidence-based understandingof costs and benefits is needed and is essentialto inform providers contemplating purchase of healthIT systems. In addition, such an understanding canprovide useful and reliable information to policymakers,payers, employers, and others who seek to influencehealth IT adoption. ASPE is designing an evaluationto assess the business case for health IT in PACand long-term care settings and to provide additionalsupport for a keystone of the Department’s vision forthe health care delivery system of the future.HHS Strategic Plan FY 2007-2012141
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