Project 2025 Tracker / What’s done, what’s next

14. Department of Health and Human Services · Minor

Adopt outcome-based metrics across HHS

Not started

452 14. Department of Health and Human Services

“Finally, HHS should adopt metrics across the agency that can objectively determine the extent to which the agency’s policies and programs achieve desired health and welfare outcomes (not agency outputs).”

What has happened

  1. Not started

    No department-wide outcome metric framework was adopted. Full-text Federal Register searches since 2025-01-20 for "outcome-based metrics" return three documents, all Education or Homeland Security; restricted to HHS, "outcome-based" returns thirteen and "outcome measures" forty-six, every one of them either a CMS payment rule using the phrase in passing or a routine Paperwork Reduction Act clearance for a single program's performance data (HRSA telehealth, LIHEAP, the Home Visiting Program, Rural Communities Opioid Response). "Government Performance and Results" restricted to HHS returns twelve, all of the same kind — program-level GPRA collections that pre-date the window. The two executive orders that come closest carry no metrics at all: EO 14212 (Make America Healthy Again) directs its Commission to "evaluate the effectiveness of current Federal Government childhood health data and metrics", which is a review of child-health statistics rather than an HHS-wide outcome framework, and EO 14332 (Improving Oversight of Federal Grantmaking) contains the words "outcome", "metric" and "measurable" zero times. The two department documents that would carry such a framework were read on 2026-09-03 and neither does. **There is no current HHS Strategic Plan**: the department's strategic-plan page says "Updated Strategic Plan forthcoming" and is stamped "Content last reviewed January 30, 2025", and the FY 2027 Agency Performance Plan and Report says the same from the other side — "The FY 2026 – 2030 HHS Strategic Plan will be published Spring 2026. This report uses a generic strategic framework" of four bare goal headings with no objectives and no measures attached. **The Annual Performance Plan exists, is in-window, and adopts no new metric framework**: it states that "HHS monitors over 600 performance measures" and that, as required by GPRAMA, "this report includes a representative set" of them — the pre-existing program-level GPRA collection, presented division by division, with no statement anywhere that HHS has adopted outcome metrics across the agency and no section distinguishing outcome from output measurement. This is the moved-nearby device: the exact document that would carry the framework, dated and Primary, and it does not carry it. Correction to an earlier pass: the note previously said performance.gov "lists no Agency Priority Goals of its own" — the APGs do exist, published on hhs.gov (page reviewed 2026-08-03), and they are four in number with overwhelmingly output and process targets ("Onboard 100% of HHS Divisions", "at least 50 medical schools", "10 targeted training sessions"). Four priority goals are not metrics across the agency.

Research log

What was searched, and what didn’t count as evidence

Research notes

  • hhs.gov can be read, and one character hid the performance documents. The department’s performance hub is at /about/budget/peformance/ — HHS’s own path carries the typo, and /about/budget/performance/ does not exist. That is why earlier searches recorded this as unreadable. Both documents are now read and cited above (2026-09-03).
  • This was once classed as one of the minor asks that cannot be verified by their nature. That framing no longer holds for this item: the department’s own planning documents have been read, and not started now means “the document that would carry an agency-wide outcome framework says it uses a generic framework and a representative set of the existing 600+ measures”, not “HHS measures nothing”.
  • The MAHA Commission’s Make Our Children Healthy Again Assessment and Strategy (EO 14212 §5) are on whitehouse.gov and can be opened — the earlier note that they “could not be found on an allowlisted domain” was wrong. They were not re-opened on 2026-09-03 and are a lead: the read that located them reports the Strategy’s nearest passage as “HHS and CMS will develop quality measures that promote children’s health outcomes rather than just healthcare utilization”, which is scoped to children’s health quality measures in CMS programs, not to HHS’s policies and programs across the agency. A plan that states a general goal in the ask’s subject area does not move the Status, so it would not move it even if cited.
  • The same-instrument pairing. https://www.hhs.gov/about/strategic-plan/index.html is the shared citation for this item and for #1365 (restore the HHS mission statement “from conception to natural death”). It does different work in each: here it shows there is no plan to carry an outcome-metric framework; there it shows there is no plan to carry the mission statement, and that the phrase is absent from the page. Recorded in both notes.
  • One search, run 2026-09-01, covered the four p. 452 asks: this one, #1202, #1203 and #1204.
  • Regulatory agenda, checked 2026-09-01. Checked against the full HHS agenda on reginfo.gov (183 active RINs in the 2026 Unified Agenda, published 2026-08-14), not the abbreviated version the Federal Register prints. The nearest entry is recorded here; it does not name this ask’s object, so the Status is unchanged — an agenda entry that states a general goal in the ask’s subject area does not move the Status.
    • HRSA’s RIN 0906-AB37, Establishing a Data-Driven Methodology for Agency Updates to Program Policy (Proposed Rule Stage, NPRM 11/2026), would set internal HRSA processes for future regulatory and sub-regulatory updates. It is one operating division deciding how it makes policy, not the department-wide adoption of metrics that measure whether programs achieve health and welfare outcomes. No other entry in the 183 touches agency metrics.
Action
create
Object
agency-wide HHS outcome metrics
ID
1205