Health Line of Business Revised Health Domains

1. Health Line of BusinessRevised Health Domains January 26, 2005 Outcomes / Domains have been revised

2. Health Domains • Access to Care • Focuses on the access to appropriate care • Population Health and Consumer Safety • Assesses health indicators and consumer products as a means to protect and promote the health of the general population • Health Care Administration • Assures that federal health care resources are expended effectively to ensure quality, safety, and efficiency • Health Care Delivery Services • Provides and supports the delivery of health care to its beneficiaries • Health Care Research and Practitioner Education • Fosters advancements in health discovery and knowledge

3. Access to Care • Focuses on the access to appropriate care • Examples: • Streamlining efforts to receive care • Ensuring care is appropriate in terms of type of care, intensity of care, and location of care • Providing seamless access to health knowledge through a myriad of beneficiary touch points • Ensuring availability of care • Enrolling providers • Performing eligibility determination, enrollment, scheduling of appointments and resources, and managing patient movement • Ensuring referral to appropriate health-related programs • Outcome: A successful implementation will result in the population’s timely receipt of the right guidance to the right care at the right location.

4. Population Health and Consumer Safety • Assesses health indicators and consumer products as a means to protect and promote the health of the general population • Examples: • Monitoring of health, health planning, and health management of humans, animals, animal products, and plants • Tracking the spread of diseases (epidemiology) and pests • Facilitating wellness, population monitoring, health promotion, disease and injury prevention, and chronic disease management activities • Predicting the trends in population health • Evaluating the overall state of the environment and effects on human health status • Inspecting and evaluating consumer products, drugs, and foods to assess the potential risks and dangers • Evaluating and capturing emerging health threats and risks to the general population • Educating the consumer and the general population • Supporting disease registries, e.g., cancer, hepatitis C, SCI, and immunology • Outcome: A successful implementation will use surveillance and monitoring results to inform decisions that will improve health outcomes and quality of life for the general population

5. Health Care Administration • Assures that federal health care resources are expended effectively to ensure quality, safety, and efficiency • Examples: • Managing health care quality, performance, and safety • Purchasing health care • Operationalizing payment methodologies • Managing cost, workload, utilization, and fraud and abuse efforts • Identifying trends (e.g., demographics) and estimating costs • Defining benefit packages and policies • Conducting oversight and control functions • Sustaining beneficiary satisfaction • Managing resources strategically • Contracting for provider and supplier participation • Improving operational efficiencies significantly • Assuring regulatory and accreditation compliance • Managing use and disclosure of patient information (to be applied across all domains) • Outcome: A successful implementation will dedicate federal health care resources in a manner to ensure efficiency/cost-effectiveness, improve patient satisfaction and health status, and optimize fiscal stewardship.

6. Health Care Delivery Services • Provides and supports the delivery of health care to its beneficiaries • Examples: • Assessing health status • Planning health services • Delivering the continuum of care (including ancillary and allied health services) • Managing clinical information and documentation • Coordinating with business partners and integrating health services • Ensuring quality of services • Ensuring care and continuity during national emergencies • Outcome:A successful implementation will be individual patient optimal health outcomes that result from informed clinical practice, an emphasis on patient-specific quality of care, and an increased focus on health promotion.

7. Health Care Research and Practitioner Education • Fosters advancements in health discovery and knowledge • Examples: • Developing new strategies for diagnosing, treating, and preventing diseases • Promoting health knowledge advancement and innovation and enabling the dissemination of medical research results • Protecting and improving health • Identifying new means for delivery of services, methods, decision models, and practices • Making strides in quality improvement • Conducting biomedical, behavioral, and rehabilitation research • Conducting and managing clinical trials • Managing research quality, performance, and subject safety • Providing for practitioner education • Outcome:A successful implementation will accelerate medical discovery, improve dissemination of evidence-based medicine and provide for practitioner education as critical elements of improving people’s health.

8. Outcomes across the Federal Health Enterprise • Access to Care: A successful implementation will result in the population’s timely receipt of the right guidance to the right care at the right location. • Population Health and Consumer Safety: A successful implementation will use surveillance and monitoring results to inform decisions that will improve health outcomes and quality of life for the general population. • Health Care Administration: A successful implementation will dedicate federal health care resources in a manner to ensure efficiency/cost-effectiveness, improve patient satisfaction and health status, and optimize fiscal stewardship. • Health Care Research and Practitioner Education: A successful implementation will accelerate medical discovery, improve dissemination of evidence-based medicine and provide for practitioner education as critical elements of improving people’s health. • Health Care Delivery Services: A successful implementation will be individual patient optimal health outcomes that result from informed clinical practice, an emphasis on patient-specific quality of care, and an increased focus on health promotion.