Performance Improvement 2000. Foreword


Performance Improvement 2000: Evaluation Activities of the U.S. Department of Health and Human Services is the sixth annual report to Congress summarizing previous fiscal year evaluation efforts. The purpose of this report is to provide Congress with evaluative information on the Department’s programs, policies, activities, and strategies. It contains brief summaries of evaluation results and provides a federal agency contact name for obtaining more detailed information. The report is useful to health and human service researchers, stakeholders and practitioners who use the information to assist their work.

In the era of results-oriented management, evaluations are playing an increasingly important role in program improvement. To this end, the Department of Health and Human Services (HHS) is committed to ensuring its evaluations yield valuable knowledge, and that knowledge is used to improve program performance. This is a consistent theme of our annual reports. Evaluations summarized in this report contribute to program improvement in four ways.

Program effectiveness studies provide a way to determine the impact of HHS programs on achieving intended goals and objectives. In fiscal year 1999, the Centers for Disease Control and Prevention (CDC) evaluated its Prevention Marketing Initiative, a 5-year demonstration of social marketing techniques combined with community participation, to reduce the risk of AIDS in young people. In selected sites, the demonstration proved successful in changing attitudes, knowledge, and sexual behavior of high risk teenagers. Recommendations for replicating the prevention model in other communities are an important contribution of the evaluation.

Performance measurement is the primary mechanism used to monitor annual progress in achieving departmental strategic and performance goals. To support performance measurement, HHS agencies are investing evaluation funds to develop and improve performance measurement systems and the quality of the data that supports those systems. For example, the Agency for Healthcare Research and Quality (AHRQ) created an inventory of clinical, population, and system performance measures for the purposes of identifying gaps and overlaps in measures and better coordinate their use.

Environmental assessment is the way we understand the forces of change in the health and human services environment that will influence the success of our programs and the achievement of our goals and objectives. In turn, this understanding allows us to adjust our strategies and continue to deliver effective health and human services. The Health Resources and Services Administration (HRSA) studied patient enrollment and assignment policies of Medicaid managed care plans on federally-qualified health centers to better understand issues for access to care for uninsured persons and healthcare quality.

Program management reflects the need of program managers to obtain information or data helpful for effectively designing and managing a program. These evaluations generally focus on developmental or operational aspects of program activities and provide understanding of services delivered and populations served. The National Institutes of Health (NIH) surveyed research grant applicants to measure their satisfaction with NIH's grant application and review process. Respondents offered suggestions for improving grant application forms and submission practices, use of electronic submissions, use of more expert reviewers, and ways to reduce waiting times.

Performance Improvement 2000 contains information on HHS evaluation projects completed and in progress during fiscal year (FY) 1999. The report is organized into three chapters. Chapter I provides an overview of HHS uses of evaluation, resources, planning, quality control and dissemination. Chapter II highlights the results from six FY 1999 evaluations, selected by an outside review panel as outstanding for their potential use by the larger health and human services community. Chapter III presents summaries of all FY 1999 evaluations completed and in progress by the 11 HHS agencies and the Office of the Secretary. The criteria used by the Evaluation Review Panel to select the reports highlighted in chapter II are presented in the Appendix.

We hope that you will find this report useful and informative.

Donna E. Shalala
U.S. Department of Health
      Margaret A. Hamburg, M.D.
Assistant Secretary for
   Planning and Evaluation