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PSC Chief Financial Officer Discusses Role on ReImagine HHS

Bill McCabe, Director, Financial Management and Procurement Portfolio and Chief Financial Officer, PSC, was interviewed about his role on ReImagine HHS, an initiative begun by U.S. Department of Health and Human Services (HHS) Secretary Tom Price, MD. Mr. McCabe was selected to serve on a workgroup for two weeks.

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What is ReImagine HHS?

The initiative was established to determine how HHS can best achieve its mission and better serve the American people. That was the goal — to streamline our operations, be more effective, and be more efficient. This is an opportunity to improve the outcomes for all Americans who are served by HHS, which is a huge portion of the population.

Secretary Price sent a memo to HHS OpDiv and StaffDiv heads on May 2 with a call to action for ReImagine HHS. He also delivered a speech in the Great Hall in the Humphrey Building informing us about the process to reimagine what we do, how we can do it better and more efficiently — overall, how we can best serve our customers. That was his goal, and that was also my goal.

He noted that he sees this effort as an opportunity to improve outcomes for all who are served by HHS. We are engaging in a process to reimagine how we work and how we deploy the American taxpayers’ financial resources, and the vast array of people, physical assets, and intellectual and institutional knowledge that exist with HHS today to better serve Americans now and well into the future.

He went on to say, here’s how we’re going to do it with six values. That is critical about his way of thinking, how we’re going to develop ideas, the things he wanted us to think about. The effort is guided by the values of engagement, empowerment, service, performance, stewardship, and sustainability. These were the guidelines that led us through our two-week reimagining process and will be the guidelines going forward as well.

How did the initiative originate?

The initiative originated from the White House and was driven by Executive Order 13781 from the president. The Office of Management and Budget (OMB) published memorandum M-17-22 with more detailed guidance and suggestions as to how to implement the executive order (EO). The EO impacts everyone within the executive branch. So it’s not just HHS; it’s all the departments under the executive branch. Anyone in a cabinet-level agency would be involved in this. One of the things that Secretary Price wanted to do is set up ways to get a lot of people and employees involved in the process.

What is your role, and how is PSC helping with the initiative?

There were five workgroups that focused on a given area within the HHS mission: health care system, public health, economic and social well-being, scientific advancement, and management and stewardship. I was a member of the management and stewardship team along with PSC Director Al Sample. There were like 40 people on this team. We came up with approximately six ideas and presented them to a steering committee. I think they were well received and will be at acted on to one extent or another.

“ReImagine HHS empowers every member of the HHS team. … It will have governmentwide impact.”

― Bill McCabe, Financial Management and Procurement Portfolio and Chief Financial Officer, PSC

The five teams came up with 28 suggestions that they forwarded to the steering and executive committees. On the last day, the teams presented the 28 different initiatives or ideas as to how to make HHS better, faster, cheaper, and more economical.

I think the initiative was even bigger than the people imagined. They set up an e-suggestion box, and from what I understand, they received over 6,000 suggestions early on — so virtually all HHS employees were given the opportunity to participate in one manner or another. I think that shows the wide array of people who were interested in reimagining HHS with ideas and suggestions. That's pretty amazing.

That's almost 10 percent of our employees who contributed, so it's a pretty significant return. The suggestions are going to be sifted through and some are valid and will be used. In addition to that, I understand OMB set up a notice in the Federal Register (an official journal of the U.S. federal government) and asked for comments. The notice was on redesigning and reimagining government as a whole — not just HHS. I understand they received huge amounts of comments — like 60,000 — over the first weekend. A lot of the comments were from industry as to how to redesign government.

There are approximately 140 people on the five teams and they're not just taking input from them; there were also suggestion boxes set up and they got all kinds of suggestions internally from HHS. In addition, OMB received thousands upon thousands of comments and suggestions from industry and taxpayers and others outside the federal government as to how to be streamlined and rearranged. So there's a lot of participation in the process.

What is the timeline?

Secretary Price wants to start implementing reforms — at least initially — in September. In the timeline, a high-level draft of the Agency Reform Plan went to OMB by June 30. In July there is implementation of initial reforms. By September, the Secretary needs a full flushed-out plan. That plan will be incorporated into our budget by February of fiscal year 2018. It will include changes and streamlining that will take place. It's going to happen relatively soon in government terms. It’s not a five- or 10-year project. Even though it won't all be completed in this amount of time, it will begin to be implemented. So, it’s a pretty ambitious plan.

What did you think about the initiative’s approach?

They’re using sort of a bottoms-up approach from all levels of HHS from people who do the work every day. It's not just theory; it's not done at the congressional or the top level. They're asking for input, which is an important step. I think that’s very important. Whatever changes are made will not come across as dictated from the top down and just put over us like a blanket. A lot of it will be brought up from people who suggested it. I think that’s an excellent approach.

So, I think they’ve gone out of their way to solicit input. Everyone was entitled to give input. Every HHS employee either directly or indirectly through the suggestion boxes, through OMB, they asked for government, citizen participation in the way government should be streamlined. I think they've kind of bent over backwards to make sure everyone has the opportunity to make suggestions on how we can make the place better, more efficient.

I think organizations that survive the best and prosper are the ones who are continually looking to reinvent themselves. I think that's the secret to success at least in the corporate arena. In the commercial arena, they have to change with the times. I'm not sure the last time government or HHS went through something like this, but it's probably been quite a while. I think it's timely that we're doing this now.

It's always good to get introspective and look at yourself and see if you're doing things the correct way or if you're just doing them like we did a decade or more ago. So it comes under continuous improvement, continuously reinventing yourself, adopting new processes, functions, technology, and applying them. I think that would be helpful in medicine, and in general in the health fields.

How has your experience been with ReImagine HHS?

It was an honor to be selected as part of the team and to give input. However, all HHS employees were given the opportunity. So, even though it was an honor to be part of the team, I wasn't alone. Everybody was allowed to comment via the e-suggestion box.

We spent two weeks developing this. We sifted through a lot of ideas the first week. There are a lot of ideas, a lot of things thrown out, a lot of things mentioned, a lot of things brought to light. We selected the best ones and that was all done in the first week. The second week was refining and honing the ones we wanted to present to the steering committee.

Al and I pushed forward ideas for reducing cost, streamlining services, and better customer experience through shared services. That's kind of our focus. That was the idea for the whole team that we presented on and it was accepted. That idea of shared services was presented to the steering and executive committees — the expansion of what we do, really. Not that shared services is a new idea in HHS; we’ve been providing shared services for quite a while — since 1995. But, the expansion of it to more services, to more people across government, and improve customer service, all those things — that’s a new approach.

The experience has been great so far. I’m always kind of an outcome-driven person. I want to see some of these improvements — at least a majority get implemented and have the impact that we believe they will. The real test is in the outcomes, how many get implemented, how many get done, how many are successful. So it’s the outcomes. That’s the true test, not theory. It's one thing to bring a lot of suggestions to the table and a lot of proposals. It's the implementation and operationalization of these ideas that will be the true test. Also, the outcomes that we receive from them.

This will be self-improvement, but also it will impact HHS in general and other government agencies that we’re able to serve. So it will have a governmentwide impact, not just HHS. It should be outcome-based. We should be able to deliver services better, cheaper, faster.

I think there’s going to be a lot of budget pressures in our future — fiscal year 2018, 2019, and 2020. So people are going to be looking to organizations and entities in HHS and external to HHS for ways to save money. This initiative, with its proposals and ideas, is an offering we’ll be able to make to them to help attain the president’s goals.