Overview: HHS Strategic Plan FY 2022–2026

Strategic Plan Development

Every four years, HHS updates its strategic plan, which describes its work to address complex, multifaceted, and evolving health and human services issues.  An agency strategic plan is one of three main elements required by the Government Performance and Results Act (GPRA) of 1993 (P.L. 103-62) and the GPRA Modernization Act of 2010 (P.L. 111-352).  An agency strategic plan defines its mission, goals, objectives, and how it will measure its progress in addressing specific national problems over a four-year period.  OMB Circular A-11, Preparation, Submission, and Execution of the Budget, Part 6, Strategic Plans, Annual Performance Plans, Performance Reviews, and Annual Program Performance Reports provided guidance on how to prepare this Strategic Plan.

All operating and staff divisions within HHS contributed to the development of the HHS Strategic Plan FY 2022–2026 (Strategic Plan), as reflected in its strategic goals, objectives, and strategies.

Strategic Goals, Objectives, and Strategies

This Strategic Plan describes HHS's efforts within the context of five broad strategic goals:

  • Strategic Goal 1: Protect and Strengthen Equitable Access to High Quality and Affordable Healthcare
  • Strategic Goal 2: Safeguard and Improve National and Global Health Conditions and Outcomes
  • Strategic Goal 3: Strengthen Social Well-being, Equity, and Economic Resilience
  • Strategic Goal 4: Restore Trust and Accelerate Advancements in Science and Research for All
  • Strategic Goal 5: Advance Strategic Management to Build Trust, Transparency, and Accountability

The strategic goals and associated objectives focus on the major functions of HHS.  High-level strategies for accomplishing HHS's goals are presented within each objective.  Although the strategic goals and objectives presented in the Strategic Plan are separate sections, they are interrelated, and successful achievement of one strategic goal or objective can influence the success of others.  Multiple divisions within HHS often contribute to successful achievement of a strategic goal or objective; divisions that make these contributions to strategic goals and objectives are listed within the appropriate sections of the Strategic Plan.

The strategies presented are not intended to be an exhaustive list, but a select set of high-level strategies that are intended to lead to positive outcomes in each area.

The strategic goals, objectives, and strategies align with Administration priorities and terminology identified in Executive Orders, White House Action Plans, Directives, and Memoranda.  Each goal also includes a list of related legislation.

In the context of HHS, this Strategic Plan adopts the definition of underserved communities listed in Executive Order 13985: Advancing Racial Equity and Support for Underserved Communities through the Federal Government to refer to "populations sharing a particular characteristic, as well as geographic communities, who have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life"; this definition includes individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, and Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality.  Individuals may belong to more than one underserved community and face intersecting barriers.  This definition applies to the terms underserved communities and underserved populations throughout this Strategic Plan.

Stakeholder Engagement

Under the GPRA Modernization Act, federal agencies are required to consult with Congress and to solicit and consider the views and suggestions of entities potentially affected by or interested in the plan.  To comply with this mandate, HHS engaged the public through the HHS website, a Notice of Availability in the Federal Register, conference calls and consultation sessions with tribal leaders, email notices to external stakeholders and HHS.gov subscribers, and social media postings.  The public could review the draft Strategic Plan on the HHS website or could request an electronic or paper copy.  The public was able to submit comments via mail, fax, email, and the HHS website.  HHS also sought input from Congress and the Office of Management and Budget.

HHS received comments from the public—including individuals, tribes, and organizations—during a 30-day public comment period.  HHS hosted a tribal consultation to solicit input from Tribal and Urban Indian Organization Leaders.  Members of Congress also sent feedback on the draft.  Input ranged from editorial suggestions to more substantive comments.  In response, subject matter experts, policy and program analysts, and research and evaluation staff from across HHS operating and staff divisions incorporated responsive changes into the final Strategic Plan.

Any updates to the Strategic Plan will be made on an annual basis, and updates will be outlined in an appendix.

HHS Strategic Plan Cross-Cutting Principles

The following cross-cutting principles demonstrate the Department's focus on embedding equity, trust, engagement, and learning into strategies to achieve the HHS mission:

  1. Equity and Inclusion: Advance equity, address social determinants of health, and support underserved communities in all of HHS programs, policies, and management practices; consistent with federal civil rights and anti-discrimination laws, and uphold the following three key principles related to Executive Order 13985: Advancing Racial Equity and Support for Underserved Communities Through the Federal Government:
  • Advancing equity must be a core part of management and the policy making processes
  • Successful equity work yields tangible changes that positively impact American lives
  • Equity benefits not just some of us, but all Americans
  1. Restore Trust: Strengthen the public's trust with HHS by leading with science, data, honesty, and share the facts as we know them.
  2. Health Literacy and Plain Language Information Sharing: Make it easier and less complex for individuals, families, and caregivers to understand health-care options and make informed decisions for healthier lifestyles.
  3. Stakeholder & Partner Engagement: Engage with state, local, and tribal governments, elected officials throughout U.S. territories and freely associated states, religious and secular organizations, and families and individuals to understand their lived experiences, needs and hear their ideas.  Of noted significance, the federal government has a unique government to government relationship with tribal nations and must establish regular and meaningful consultation and collaboration with tribal officials in the development of federal policies that have tribal implications, as outlined in Executive Order 13175: Consultation and Coordination with Indian Tribal Governments and carried out through the HHS Tribal Consultation Policy.
  4. Agility, Learning, and Innovation: Work across organizational boundaries to remove barriers, leverage capabilities, and apply lessons learned to create innovative, responsive solutions to multi-dimensional health and human service issues. 

Strategic Management at HHS

HHS is working to integrate strategic planning, performance measurement and management, enterprise risk management, and evaluation and evidence into its management approach.  The sections that follow—Performance Tracking, Major Management Priorities and Challenges, and Evaluation and Evidence—highlight strategic management efforts that are aligned in the context of the Strategic Plan.

Performance Tracking

Performance Goals. The GPRA Modernization Act and related guidance from the Office of Management and Budget requires the inclusion of performance goals for each Strategic Objective in the Strategic Plan.  In developing and selecting performance goals, HHS included measures of the broad impact of health and human services as well as intermediate processes and outputs that contribute to the achievement of long-term outcomes.  HHS personnel regularly monitor more than 900 performance measures to examine effectiveness and improve program processes.  This Strategic Plan includes a subset of important performance goals that track progress for those objectives.  Progress on these performance goals will be tracked annually through the Annual Performance Report.

Agency Priority Goals. Among the performance measures monitored by the Department are several measures that support the Department's Priority Goals.  These goals are a set of ambitious but realistic performance objectives that the Department will work to achieve within a 24-month period.  Agency Priority Goals support and align with the Strategic Goals and Objectives of the HHS Strategic Plan.  The GPRA Modernization Act requires the inclusion of these Priority Goals in the Department's Strategic Plan and Annual Performance Plan.  Agency Priority Goals for FY 2022–2023 will be reported in Annual Performance Plans and Reports beginning in 2022.  Current information on Agency Priority Goals can be found at https://www.Performance.gov.

Cross-Agency Priority Goals. The GPRA Modernization Act requires that the Department address Cross-Agency Priority (CAP) Goals in its quadrennial Strategic Plan, the Annual Performance Plan, and the Annual Performance Report.  Once the CAP goals are determined, the Department's contributions to and progress on CAP Goals will be available at https://www.Performance.gov.

Major Management Priorities and Challenges

According to OMB Circular A-11, an agency's strategic plan must include a section on major management challenges, to describe management and programmatic issues and risks or areas that have greater vulnerability to waste, fraud, abuse, and mismanagement or where a failure to perform could seriously affect the agency's mission delivery and ability to achieve its goals.  The Office of Inspector General (OIG) annually identifies top management and performance challenges facing the Department as it strives to fulfill its mission.  OIG notes that challenges can arise in the Department's responsibilities and functions, such as safeguarding public health and safety, ensuring financial integrity, delivering quality services and benefits, and harnessing data.  Efforts to strengthen these functions are described in Strategic Goal 5: Advance Strategic Management to Build Trust, Transparency, and Accountability.  OIG also identified challenges that exist in programs, including Medicare and Medicaid, and between program collaboration across the Department.  The Government Accountability Office (GAO) has listed several HHS programs, including public health emergency coordination, Medicare, Medicaid, food safety, medical product oversight, and drug misuse on its High Risk List, which lists programs or activities with greater vulnerabilities to fraud, waste, abuse, and mismanagement.  Several other items on the GAO High Risk List also involve HHS: Improving Federal Management of Programs that Serve Tribes and Their Members; Improving and Modernizing Federal Disability Programs; Improving the Management of IT Acquisitions and Operations; and Ensuring the Cybersecurity of the Nation.  Efforts to strengthen these programs are described across Strategic Goal 1: Protect and Strengthen Equitable Access to High Quality and Affordable Healthcare and Strategic Goal 2: Safeguard and Improve National and Global Health Conditions and Outcomes.  In addition to responding to risks identified by OIG and GAO, the Department is implementing an enterprise risk management (ERM) approach to its work.  References to ERM are included throughout the document, especially in Strategic Goal 5: Advance Strategic Management to Build Trust, Transparency, and Accountability.

Evaluation and Evidence for the HHS Strategic Plan

Evaluation and analysis provide essential evidence for HHS to understand how, for whom, and under what circumstances its programs work.  HHS builds evidence through evaluation and analysis to inform decisions in budget, legislative, regulatory, strategic planning, program, and policy arenas.  Given the breadth of work supported by HHS, many evaluations and analyses are conducted each year.  These efforts range in scope, scale, design, and methodology, but all aim to understand the effect of programs and policies and how they can be improved.

Evaluation at HHS: Across HHS, evaluation comes in many forms, including (1) formal program evaluations using the most rigorous designs that are appropriate; (2) capacity-building initiatives to improve administrative data collection, accessibility, and use for management; (3) exploratory and preliminary quantitative and qualitative analysis to build evidence; (4) pilots and demonstrations; and (5) statistical analysis of factors related to health and human services programs and policies.  Evaluation approaches are guided by the HHS Evaluation policy.  Findings from a variety of evaluations and analyses are disseminated to the public on HHS agency websites, such as those of the Administration for Children and Families Office of Planning, Research, and Evaluation and the Innovation Center at the Centers for Medicare & Medicaid Services.  HHS coordinates the evaluation community by regularly convening the HHS Evaluation & Evidence Policy Council, which builds capacity by sharing best practices and promising new approaches across HHS. 

Additional information about evaluation at HHS is available in the HHS FY 2024 Evaluation Plan and the FY 2023-2026 HHS Evidence-Building Plan.

Data Collection, Analysis, and Policy: Across HHS, decisions about programs, regulations, and policies are informed by a broad range of evidence generated through analysis of data collected from multiple sources.  The robust HHS data portfolio serves as the foundation for evidence building.  The data collection systems supported by HHS provide most of the national statistical capacity to monitor the health of the population and the functioning of the healthcare and human services systems.  They support the tracking of national health objectives and the identification of trends, and they inform program and policy decision making associated with the missions of all HHS agencies. Evidence is developed by analyzing data to answer policy research questions.  Data policy shapes the information available for evidence-building to support decision making. HHS also convenes the HHS Data Council, the principal internal advisory body to the Secretary of HHS on data and statistical policy, which facilitates collaboration and coordination among various divisions involved in evidence building.  An important activity of the HHS Data Council includes leveraging HHS statistical and administrative data collection to support evidence building.

Disseminating Evidence: In addition to building evidence through a broad range of rigorous empirical studies, analyses, and evaluations, HHS supports multiple clearinghouses that catalog, review, and disseminate evidence related to programs, such as the Administration for Children and Families Research and Evaluation Clearinghouses on Self-Sufficiency, Home Visiting, and Child Care and Early Education; the Agency for Healthcare Quality and Research United States Preventive Services Task Force; and the Centers for Disease Control and Prevention Community Guide.

Throughout this Strategic Plan, narrative sections under the Strategic Goals and Objectives describe how evaluations contributed to the strategic directions that the Department has chosen in its efforts to improve health and human services for the populations it serves.  This Strategic Plan also includes strategies related to conducting research and evaluations and applying that knowledge to improve programs and other efforts.

Contributing Programs for Strategic Objectives

The Government Performance and Results Act Modernization Act of 2010 (GPRAMA), as amended by the William M. (Mac) Thornberry National Defense Authorization Act for Fiscal Year 2021 (NDAA), requires the Office of Management and Budget (OMB) to develop a single website that provides a "coherent picture of all Federal programs, and the performance of the Federal Government as well as individual agencies."  This program inventory is intended to facilitate coordination across programs, make it easier to find programs that contribute to a shared goal, and improve public understanding about what federal programs do and how the programs link to budget, performance, and other information.

HHS is working with OMB to update its GPRAMA-required program inventory through an iterative process described in the Federal Program Inventory Implementation Plan.  HHS maintains an inventory of programs through the Department's budget structure and Treasury accounts.  This approach is consistent with how the Department operates and serves the American people and generally reflects the way Congress appropriates funding to HHS.

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