Executive Summary

This Annual Report is organized into five sections corresponding to the HHS department strategic goals as laid out in our 2018-2022 strategic plan.

Goal 1: Reform, Strengthen, and Modernize the Nation’s Health Care System

HHS endeavors to improve the quality and reduce the cost of healthcare Americans receive through reforming the programs the department runs, advancing the direct care provided in our programs, and ensuring government incentives do not prevent patients and providers from working together to drive value. Accomplishments in this section include:

• Releasing and implementing the American Patients First drug pricing blueprint.
• Empowering pharmacists to always be able to tell patients what the least expensive option for their medicine is through legislation banning pharmacy gag clauses.
• Historic approvals from FDA, with a record 59 novel drugs or biological products approved and a record number of generic drug approvals for the second straight fiscal year.
• For the first time since their inception, the average premium on a benchmark plan on HealthCare.gov was lowered by about 1.5 percent.
• Expanding Association Health Plans, making it easier for employers to join together to offer more affordable coverage to their workers.
• Finalizing a rule expanding availability of short-term, limited-duration insurance, which tend to be nearly 50 percent cheaper than plans under the ACA.

Goal 2: Protect the Health and Well-Being of Americans Where They Live, Learn, Work, and Play

HHS’s work to protect the health of Americans extends from addressing the most pressing public health threats in our local communities, including the opioid crisis, HIV, and other infectious diseases, all the way to addressing and preventing health threats around the world. Covered in this section are accomplishments including:

• Awarding $1 billion through the State Opioid Response grant program to fight the epidemic.
• Nearly doubling NIH funding for research into pain and addiction, to $1.1 billion, as part of the HEAL Initiative.
• Using science to update the comprehensive strategic framework for tackling the opioid crisis.
• Deployed more than 1,050 U.S. Public Health Commissioned Corps officers and other HHS staff throughout 2018 to respond to national emergencies, natural disasters, and other public health crises and missions.
• Led the launch of the first ever National Biodefense Strategy.
• First-ever Humanitarian Service Medal awarded to the Public Health Service Commissioned Corps and other HHS staff for a large deployment.

Goal 3: Strengthen the Economic and Social Well-Being of Americans across the Lifespan

From delivering health visits for new moms and supporting Early Start locations across America, to supporting aging and disability networks that help older Americans live in their communities longer than ever before, HHS plays a vital role in providing human ser­vices to vulnerable Americans at all stages of life. This section covers items such as:

• CMS approving first-ever state demonstrations incentivizing work and community engagement among a large population spanning five states.
• Continuing to protect conscience and life in healthcare settings by launching a conscience division within the HHS Office of Civil Rights.
• Issuing a final rule providing regulatory relief to employers like the Little Sisters of the Poor, protecting conscience rights.
• Working with the VA to expand the Veteran-Directed Care program, which uses aging and disability networks to support veterans living in their communities rather than in nursing homes.

Goal 4: Foster Sound, Sustained Advances in the Sciences

HHS is proud to be home not just to many of the world’s preeminent individual scientists, public health experts, and clinicians, but also the world’s finest scientific institutions: the largest single source of biomedical research funding in the world in NIH, the world’s premier epidemiological institution in CDC, and the world’s gold-standard food and drug safety agency in FDA. This section covers our work including:

• Creating the unprecedented All of Us long-term research study with the National Institutes of Health, in which 150,00 people have already signed up to participate.
• Advancing the Cancer Moonshot with more than $300 million in 2018 research investments.
• Launching an Accelerating Medicines Partnership focusing on identifying and validating promising markers of Parkinson’s Disease.
• Fostering collaboration between NIH and the VA to boost veterans’ access to cancer clinical trials.

Goal 5: Promote Effective and Efficient Management and Stewardship

In 2018, HHS took major steps forward in de­partmental management, from reforms of the regulatory burdens it places on healthcare and human services partners to developing new tools for improving departmental and financial management. Included in this section:

• Charging over 600 individuals in fraud that cost $2 billion in losses to Medicare and Medicaid as part of the largest National Healthcare Fraud Takedown Day in history.
• Reducing the present-value economic burden of HHS regulations by $12.5 billion — more than half of the deregulatory burden reduction for the entire administration in 2018.
• Grants.gov posting 5,798 funding opportunities and processed over 227,160 applications, running 100 percent operational with no unscheduled outages.
• Ranked as the second best large federal agency to work at for the second straight year.
• Cutting improper payments in Medicare and Medicaid by $4.6 billion from 2017 to 2018.