Transit in the U.S. is considered secondary to automobile travel; bus services are especially stigmatized. Facing declining ridership and overall diminished financial support, many agencies are confronted with making difficult choices about how to supply efficient and effective services. We analyze the 2019 National Transit Database focusing on U.S. agencies providing bus services. We study three measures each of efficiency (cost per vehicle revenue mile, fare revenues per unlinked passenger trip, and vehicle revenue miles per employee hours) and effectiveness (cost per unlinked passenger trip, unlinked passenger trips per vehicle revenue mile, and unlinked passenger trips per vehicle revenue hour). We focus on agency attributes, service characteristics, and operations and management plus capital spending. The research indicates that agencies could consider outsourcing services that are necessary but might otherwise be a drain on agency resources. Agencies should balance the efficiencies of higher speed bus service with more effective service. Planners, engineers, and stakeholders working with transit agencies need to be cautious about which outcomes to focus on if costs are to decrease, while efficiency and effectiveness of bus services are to increase. Specifically, outsourcing has differing impacts based on agency size. Our work underscores the importance of operations and management spending, coupled with strategic capital expenditure.