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

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CHAPTER 2: Health careMeeting External ChallengesHHS faces a number of challenges in improving thesafety, quality, affordability, and accessibility of healthcare, including shifting demographics, changing trendsin demand, increasing costs, and continuing concernsabout implementing new technologies.Demographic changes include the aging of the Nation’spopulation and increasing life expectancy, a growingnumber of persons with disabilities, and an increasingnumber of populations who do not speak Englishand have low literacy. HHS is working to meet thechallenge by targeting its outreach materials and mediaresponses to these populations, monitoring trends inaccess and availability of care for these populations,and continuing to design and implement innovativedemonstration programs and initiatives aimed atreducing disparities. For more information about thistopic, see Chapter 4’s In the Spotlight: DemographicChanges and Their Impact on Health and Well-Being.With these demographic changes, changes in demandare expected to follow. Enhanced outreach to newpopulations means that HHS may need to thinkdifferently about responding to demands for high-quality,high-value, and accessible health care; behavioral healthcare; and long-term care. Surges in the Medicare-eligiblepopulation related to the aging of the Baby Boomersmay strain the ability of the health care delivery systemto respond appropriately. Even consumer perceptionsabout their need for preventive screenings or servicesimpact overall demand. HHS is working to analyzebackground data from services provided to react tochanging beneficiary needs. Evidence-based processesare being utilized to address coverage issues. Educationcampaigns are being conducted to raise awarenessabout beneficiary screening services and preventive care,with particular attention to growing racial and ethnicminority populations.Although the above is true, one cannot assume thatall costs are avoidable. Some of these costs substitutefor the costs of excess mortality or morbidity. TheUnited States continues to have the highest percapita health care spending among industrialized50 HHS Strategic Plan FY 2007-2012
CHAPTER 2: Health carecountries. The health care cost per capita for personsaged 65 years or older in the United States is three tofive times greater than the cost for persons youngerthan 65, and the rapid growth in the number of olderpersons, coupled with continued advances in medicaltechnology, is expected to create upward pressure onhealth care and long-term care spending. Medicalinflation also contributes to the rising cost of providingappropriate quality health services, widening the gapbetween increased need and available resources. Aneconomic downturn could increase demand for healthcare and long-term care services from safety netproviders and strain the ability of current providersto meet the demand. In response to these concerns,HHS will continue to monitor trends in access to careamong uninsured, underinsured, and low-incomeindividuals, and to design and implement innovativedemonstration programs that seek to improve healthand access to care among these groups. HHS willidentify new resources to meet increased demands,focusing on efficiency and effectiveness of health careservice delivery. HHS will also continue to cultivate astrong focus on prevention and wellness services (seeStrategic Goal 2, Objective 2.3, for more detail).Improving health care and the health of the populationthrough the adoption of health information technology(health IT) is clearly a priority for HHS (see In the Spotlight:Advancing the Development and Use of Health InformationTechnology). The nationwide implementation of aninteroperable health IT infrastructure has the potential tolower costs, reduce medical errors, improve the quality ofcare, and provide patients and physicians with new waysto interact. However, nationwide health IT adoption canbe accomplished only through a coordinated effort ofmany stakeholders, from State and Federal governmentsand the private sector. HHS has taken great care to engagerepresentatives from all of these sectors in all of our healthIT initiatives—an effort that involves many processes andthe work of many hundreds of participants. In September2005, HHS formed a Federal Advisory Committee(subject to the Federal Advisory Committee Act 4 of 1972(Public Law 92-463), as amended), the American HealthInformation Community (AHIC), to advise the Secretaryon how to accelerate the development and adoption ofhealth IT and help advance efforts needed to achieve thePresident’s goal for most Americans to have access tosecure electronic health records by 2014. Additionally, theAHIC provides input and recommendations to HHS onhow to make health records digital and interoperable andhow to protect the privacy and security of those records, ina smooth, market-led way.4 In 1972, the Federal Advisory Committee Act (Public Law 92-463) was enacted by the U.S. Congress. Its purpose was to ensurethat advice rendered to the executive branch by the various advisorycommittees, task forces, boards, and commissions formed overthe years by the Congress and the President be both objective andaccessible to the public. The act formalized a process for establishing,operating, overseeing, and terminating these advisory bodies.HHS Strategic Plan FY 2007-201251
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Appendix h: endnotesXXX.CDC. (2005)
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