Department of Health and Human Services

The Department of Health and Human Services' (HHS) mission is to protect the health of Americans and provide essential human services, especially for vulnerable populations. To support its mission, HHS's 11 agencies manage more than 300 federal health and social programs, which accounted for almost a quarter of all federal outlays in 2008. Those agencies and programs including the following:

• The Centers for Medicare & Medicaid Services (CMS) administers the largest two programs — Medicare and Medicaid, which provide health insurance for one in four Americans.


• The Food and Drug Administration (FDA) is responsible for ensuring the safety and efficacy of pharmaceuticals, biological products, and medical devices marketed in the United States and for overseeing about 80 percent of the nation's food supply.


• The Centers for Disease Control and Prevention (CDC) works to strengthen the nation's preparedness for public health emergencies, such as an influenza pandemic and bioterrorism.


• The Administration for Children and Families (ACF) administers 60 programs for children, families, and communities, including Head Start and Temporary Assistance for Needy Families (TANF).

HHS's agencies face numerous management challenges, including the following.

• Growth in Medicare expenditures places pressure on CMS to develop payment reforms to control spending while promoting improved quality.
• CMS faces challenges to improve management of Medicare and Medicaid, while difficulties in ensuring the integrity of their payments undermine CMS's efforts to curb outlays in these high-risk programs.
• CMS has had challenges overseeing patient care and safety in nursing homes and hospitals.


• Due to weaknesses in agency capacity and data, FDA has had difficulties in overseeing the safety and efficacy of medical products, and limitations in strategic planning have hampered its food-safety efforts.


• HHS's efforts to strengthen preparedness for public health emergencies have been hampered by shortages in the public health workforce.


• HHS faces challenges to oversee programs that target the well-being and economic independence of children in families. In particular, given that these programs are generally administered by states and grantees, HHS is challenged to balance the quality of services, program participation, and the integrity of these programs—which is especially critical given the potential for rising numbers of applicants and the needs of vulnerable individuals in light of recent declining economic conditions and job losses.