TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Edward H. Shortliffe A2 - Francis K. Amankwah A2 - Tracy A. Lustig A2 - Sharyl J. Nass TI - Medications in Single-Dose Vials: Implications of Discarded Drugs SN - DO - 10.17226/25911 PY - 2021 UR - https://nap.nationalacademies.org/catalog/25911/medications-in-single-dose-vials-implications-of-discarded-drugs PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Every year, significant amounts of expensive drugs are discarded. This is due in part to the growing number of prescription drugs that are administered in variable doses (rather than fixed or flat doses) based on a patient's weight or body size. Strict regulations and guidance generally prohibit or severely restrict the acceptable time frame for sharing medication from single-dose vials among patients, and so the unused amount will typically be discarded. Due to the current system for producing, administering, and paying for drugs in the United States, significant - but indeterminate - amounts of expensive prescription drugs are discarded each year. At the request of the Centers for Medicare & Medicaid Services, Medications in Single Dose Vials: Implications of Discarded Drugs explores the federal health care costs, safety, and quality concerns associated with discarded drugs that result from the weight-based dosing of medicines contained in single-dose vials. ER - TY - BOOK AU - Institute of Medicine A2 - Cheryl Ulmer A2 - John Ball A2 - Elizabeth McGlynn A2 - Shadia Bel Hamdounia TI - Essential Health Benefits: Balancing Coverage and Cost SN - DO - 10.17226/13234 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13234/essential-health-benefits-balancing-coverage-and-cost PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - In 2010, an estimated 50 million people were uninsured in the United States. A portion of the uninsured reflects unemployment rates; however, this rate is primarily a reflection of the fact that when most health plans meet an individual's needs, most times, those health plans are not affordable. Research shows that people without health insurance are more likely to experience financial burdens associated with the utilization of health care services. But even among the insured, underinsurance has emerged as a barrier to care. The Patient Protection and Affordable Care Act (ACA) has made the most comprehensive changes to the provision of health insurance since the development of Medicare and Medicaid by requiring all Americans to have health insurance by 2016. An estimated 30 million individuals who would otherwise be uninsured are expected to obtain insurance through the private health insurance market or state expansion of Medicaid programs. The success of the ACA depends on the design of the essential health benefits (EHB) package and its affordability. Essential Health Benefits recommends a process for defining, monitoring, and updating the EHB package. The book is of value to Assistant Secretary for Planning and Evaluation (ASPE) and other U.S. Department of Health and Human Services agencies, state insurance agencies, Congress, state governors, health care providers, and consumer advocates. ER - TY - BOOK AU - Institute of Medicine A2 - Cheryl Ulmer A2 - Bernadette McFadden A2 - Cassandra Cacace TI - Perspectives on Essential Health Benefits: Workshop Report SN - DO - 10.17226/13182 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13182/perspectives-on-essential-health-benefits-workshop-report PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The Patient Protection and Affordable Care Act (herein known as the Affordable Care Act [ACA]) was signed into law on March 23, 2010. Several provisions of the law went into effect in 2010 (including requirements to cover children up to age 26 and to prohibit insurance companies from denying coverage based on preexisting conditions for children). Other provisions will go into effect during 2014, including the requirement for all individuals to purchase health insurance. In 2014, insurance purchasers will be allowed, but not obliged, to buy their coverage through newly established health insurance exchanges (HIEs)--marketplaces designed to make it easier for customers to comparison shop among plans and for low and moderate income individuals to obtain public subsidies to purchase private health insurance. The exchanges will offer a choice of private health plans, and all plans must include a standard core set of covered benefits, called essential health benefits (EHBs). The Department of Health and Human Services requested that the Institute of Medicine (IOM) recommend criteria and methods for determining and updating the EHBs. In response, the IOM convened two workshops in 2011 where experts from federal and state government, as well as employers, insurers, providers, consumers, and health care researchers were asked to identify current methods for determining medical necessity, and share decision-making approaches to determining which benefits would be covered and other benefit design practices. Essential Health Benefits summarizes the presentations in this workshop. The committee's recommendations will be released in a subsequent report. ER - TY - BOOK AU - Institute of Medicine TI - Clinical Preventive Services for Women: Closing the Gaps SN - DO - 10.17226/13181 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13181/clinical-preventive-services-for-women-closing-the-gaps PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Women suffer disproportionate rates of chronic disease and disability from some conditions, and often have high out-of-pocket health care costs. The passage of the Patient Protection and Affordable Care Act of 2010 (ACA) provides the United States with an opportunity to reduce existing health disparities by providing an unprecedented level of population health care coverage. The expansion of coverage to millions of uninsured Americans and the new standards for coverage of preventive services that are included in the ACA can potentially improve the health and well-being of individuals across the United States. Women in particular stand to benefit from these additional preventive health services. Clinical Preventive Services for Women reviews the preventive services that are important to women's health and well-being. It recommends that eight preventive health services for women be added to the services that health plans will cover at no cost. The recommendations are based on a review of existing guidelines and an assessment of the evidence on the effectiveness of different preventive services. The services include improved screening for cervical cancer, sexually transmitted infections, and gestational diabetes; a fuller range of contraceptive education, counseling, methods, and services; services for pregnant women; at least one well-woman preventive care visit annually; and screening and counseling for interpersonal and domestic violence, among others. Clinical Preventive Services for Women identifies critical gaps in preventive services for women as well as measures that will further ensure optimal health and well-being. It can serve as a comprehensive guide for federal government agencies, including the Department of Health and Human Services and the Center for Disease Control and Prevention; state and local government agencies; policy makers; health care professionals; caregivers, and researchers. ER - TY - BOOK AU - Institute of Medicine A2 - Maria Hewitt TI - Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary SN - DO - 10.17226/13255 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13255/facilitating-state-health-exchange-communication-through-the-use-of-health-literate-practices PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Implementation of the Affordable Care Act (ACA) of 2010 will result in significant changes to the U.S. health care system. Among its many provisions, the ACA will extend access to health care coverage to millions of Americans who have been previously uninsured. Many of the newly eligible health insurance consumers will be individuals of low health literacy, some speakers of English and others more comfortable using languages other than English. Health insurance terms such as "deductible," "co-insurance," and "out-of-pocket limit" are difficult to communicate even to those with moderate-to-high levels of health literacy and so health exchanges will face challenges as they attempt to communicate to the broader community. In addition to having to convey some of these basic, and yet complex, principles of insurance, state exchanges will be attempting to adapt to the many changes to enrollment and eligibility brought about by ACA. The Institute of Medicine (IOM) convened the Roundtable on Health Literacy that brings together leaders from the federal government, foundations, health plans, associations, and private companies to discuss challenges facing health literacy practice and research and to identify approaches to promote health literacy in both the public and private sectors. The roundtable sponsored a workshop in Washington, DC, on July 19, 2011, that focused on ways in which health literacy can facilitate state health insurance exchange communication with potential enrollees. The roundtable's workshop focused on four topics: (1) lessons learned from existing state insurance exchanges; (2) the impact of state insurance exchanges on consumers; (3) the relevance of health literacy to health insurance exchanges; and (4) current best practices in developing materials and communicating with consumers. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices summarizes the presentations and discussion that occurred during the workshop. The report provides an overview of health insurance exchanges, presents evidence on the extent to which consumers understand underlying health insurance concepts, and describes the relevancy of health literacy to health insurance reform and how health literacy interventions can facilitate the implementation of health insurance reforms. The report also provides a review of best practices in developing materials and communicating with consumers, and concludes with reflections on the workshop presentations and discussions by members of the roundtable and its chair. Further information is provided in the appendixes, the workshop agenda (Appendix A), workshop speaker biosketches (Appendix B), and testimony provided by the organization America's Health Insurance Plans (AHIP) (Appendix C). ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Opportunities to Promote Children's Behavioral Health: Health Care Reform and Beyond: Workshop in Brief DO - 10.17226/23545 PY - 2016 UR - https://nap.nationalacademies.org/catalog/23545/opportunities-to-promote-childrens-behavioral-health-health-care-reform-and PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - The adoption of the Patient Protection and Affordable Care Act (ACA) 2010 was a turning point in the history of behavioral health for children and adolescents in the United States. The ACA requires most health insurance plans to conduct behavioral health assessments for children, as well as depression screening for adults. Looking ahead, however, questions have been raised about how to promote children's behavioral health, how to make use of innovations, and how to sustain funding over time. To respond to these questions, the Forum on Promoting Children's Cognitive, Affective, and Behavioral Health of the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, D.C., on April 1-2, 2015. The workshop focused on how recent reforms in health care provide new opportunities to promote children's cognitive, affective, and behavioral health. It also assessed behavioral health needs of all children, including those with special physical or behavioral health conditions, and programs that support families.This report summarizes the presentations and discussion of the workshop. ER - TY - BOOK AU - Institute of Medicine A2 - Maria Hewitt TI - Oral Health Literacy: Workshop Summary SN - DO - 10.17226/13484 PY - 2013 UR - https://nap.nationalacademies.org/catalog/13484/oral-health-literacy-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The Institute of Medicine (IOM) Roundtable on Health Literacy focuses on bringing together leaders from the federal government, foundations, health plans, associations, and private companies to address challenges facing health literacy practice and research and to identify approaches to promote health literacy in both the public and private sectors. The roundtable serves to educate the public, press, and policy makers regarding the issues of health literacy, sponsoring workshops to discuss approaches to resolve health literacy challenges. It also builds partnerships to move the field of health literacy forward by translating research findings into practical strategies for implementation. The Roundtable held a workshop March 29, 2012, to explore the field of oral health literacy. The workshop was organized by an independent planning committee in accordance with the procedures of the National Academy of Sciences. The planning group was composed of Sharon Barrett, Benard P. Dreyer, Alice M. Horowitz, Clarence Pearson, and Rima Rudd. The role of the workshop planning committee was limited to planning the workshop. Unlike a consensus committee report, a workshop summary may not contain conclusions and recommendations, except as expressed by and attributed to individual presenters and participants. Therefore, the summary has been prepared by the workshop rapporteur as a factual summary of what occurred at the workshop. ER - TY - BOOK AU - National Academy of Medicine A2 - Peak Sen Chua A2 - Ayodola Anise A2 - Jennifer Lee A2 - Mandy Cohen A2 - Patrick Conway A2 - Julian Harris A2 - Peter Long A2 - Mark B. McClellan A2 - David Muhlestein A2 - Amol S. Navathe A2 - Rebecca Onie A2 - Edwin Park A2 - Rocco Perla TI - Catalyzing Innovative Health System Transformation: An Opportunity Agenda for the Center for Medicare & Medicaid Innovation SN - DO - 10.17226/26675 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26675/catalyzing-innovative-health-system-transformation-an-opportunity-agenda-for-the PB - The National Academies Press CY - Washington, DC LA - English AB - Since its founding, the Center for Medicare & Medicaid Innovation (CMMI) has tested more than 50 alternative payment models reaching more than 28 million patients across 528,000 health care providers and plans, yielding invaluable insights on the implementation of models to achieve better care, better health, and lower costs. On the other hand, many basic lessons learned are lessons unapplied. U.S. population health outcomes lag behind its highly economically developed peers and our health system is still firmly entrenched in the fee-for-service payment system that rewards service volume. This Special Publication suggests six key priority actions for CMMI centered on signaling, mapping, measuring, modeling, partnering, and demonstrating. These priority actions, coupled with implementation considerations that focus on meaningful and continuous engagement, intersectionality and diversity, and expanding CMMI activities and impact, are intended to assist in aligning, supporting, and informing the implementation of CMMI’s Strategic Refresh. ER - TY - BOOK AU - Institute of Medicine A2 - Maria Hewitt TI - Improving Health Literacy Within a State: Workshop Summary SN - DO - 10.17226/13185 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13185/improving-health-literacy-within-a-state-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Health literacy is the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions. According to Health Literacy: A Prescription to End Confusion (IOM, 2004), nearly half of all American adults--90 million people--have inadequate health literacy to navigate the healthcare system. To address issues raised in that report, the Institute of Medicine convened the Roundtable on Health Literacy, which brings together leaders from the federal government, foundations, health plans, associations, and private companies to discuss challenges facing health literacy practice and research and to identify approaches to promote health literacy in both the public and private sectors. On November 30, 2010, the roundtable cosponsored a workshop with the University of California, Los Angeles (UCLA), Anderson School of Management in Los Angeles. Improving Health Literacy Within a State serves as a summary of what occurred at the workshop. The workshop focused on understanding what works to improve health literacy across a state, including how various stakeholders have a role in improving health literacy. The focus of the workshop was on presentations and discussions that address (1) the clinical impacts of health literacy improvement approaches; (2) economic outcomes of health literacy implementation; and (3) how various stakeholders can affect health literacy. ER - TY - BOOK AU - National Research Council A2 - Michele Ver Ploeg A2 - Edward Perrin TI - Eliminating Health Disparities: Measurement and Data Needs SN - DO - 10.17226/10979 PY - 2004 UR - https://nap.nationalacademies.org/catalog/10979/eliminating-health-disparities-measurement-and-data-needs PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Behavioral and Social Sciences KW - Surveys and Statistics AB - Disparities in health and health care across racial, ethnic, and socioeconomic backgrounds in the United States are well documented. The reasons for these disparities are, however, not well understood. Current data available on race, ethnicity, SEP, and accumulation and language use are severely limited. The report examines data collection and reporting systems relating to the collection of data on race, ethnicity, and socioeconomic position and offers recommendations. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Systems Practices for the Care of Socially At-Risk Populations SN - DO - 10.17226/21914 PY - 2016 UR - https://nap.nationalacademies.org/catalog/21914/systems-practices-for-the-care-of-socially-at-risk-populations PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act. ER - TY - BOOK AU - Institute of Medicine TI - Setting the Course: A Strategic Vision for Immunization Finance: Part 1: Summary of the Chicago Workshop SN - DO - 10.17226/10276 PY - 2002 UR - https://nap.nationalacademies.org/catalog/10276/setting-the-course-a-strategic-vision-for-immunization-finance-part PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The federal and state partnership in supporting immunization programs that benefit the general population evolved over the last half of the 20th century from a simple cost-sharing arrangement for vaccine purchase for disadvantaged children to a more complicated mix of programs, health care coverage benefits, and public-private partnerships. The mix of financial arrangements that support immunization efforts was the subject of a study by the Institute of Medicine, resulting in the publication of the report Calling the Shots. In June 2001, a group of 50 health officials, public health experts, health care providers, health plan representatives, and community leaders met at the University of Illinois in Chicago to explore the implications of the IOM findings and recommendations for the states of Illinois and Michigan. The one-day workshop was the first in a series of four meetings organized by IOM with support from the Centers for Disease Control and Prevention to foster informed discussions about future financing strategies for the public health infrastructure that supports immunization efforts.This report of the Chicago workshop summarizes the findings of the IOM study and reviews the challenges that remain in establishing a reliable financial base for the U.S. immunization system. The report high-lights strategies presented by workshop speakers and discussants for achieving immunization goals, including increases in state and federal public health budgets, the addition of quality improvement measures in health plans, performance-based contracting, public policy actions, and the creation of public-private partnerships. ER - TY - BOOK AU - Institute of Medicine TI - Setting the Course: A Strategic Vision for Immunization: Part 4: Summary of the Washington, D.C., Workshop SN - DO - 10.17226/10856 PY - 2003 UR - https://nap.nationalacademies.org/catalog/10856/setting-the-course-a-strategic-vision-for-immunization-part-4 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - In 2000, the Institute of Medicine (IOM) produced a report Calling the Shots: Immunization Finance Policies and Practices (IOM, 2000a) that illustrated the uncertainties and instability of the public health infrastructure that supports U.S. immunization programs. The IOM report proposed several strategies to address these concerns and to strengthen the immunization infrastructure. In March 2002, a group of 50 health officials, public health experts, health care providers, health plan representatives, health care purchasers, and community leaders met at The National Academies in Washington, DC to explore the implications of the IOM findings and recommendations for the federal and state governments. Private health plans and business sector representatives also participated in the meeting to discuss their role in fostering high levels of immunization coverage. The one-day workshop was the fourth and last in a series of meetings organized by IOM with support from the CDC to foster informed discussions about future financing strategies for immunization and the public health infrastructure. This report of the Washington, DC workshop summarizes the findings of the IOM study, reviews the implementation of the IOM recommendations, and highlights continuing immunization finance challenges for the nation as a whole as well as state and local health departments. ER - TY - BOOK AU - Institute of Medicine A2 - Marilyn J. Field A2 - Alan M. Jette TI - The Future of Disability in America SN - DO - 10.17226/11898 PY - 2007 UR - https://nap.nationalacademies.org/catalog/11898/the-future-of-disability-in-america PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society. ER - TY - BOOK AU - Institute of Medicine TI - Setting the Course: A Strategic Vision for Immunization: Part 2: Summary of the Austin Workshop SN - DO - 10.17226/10495 PY - 2002 UR - https://nap.nationalacademies.org/catalog/10495/setting-the-course-a-strategic-vision-for-immunization-part-2 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Immunization is essential to disease prevention efforts in public health, but the U.S. health care system faces financial challenges that are affecting the delivery of immunization services. An earlier report from the Institute of Medicine (IOM), Calling the Shots: Immunization Finance Policies and Practices, pointed to the instability of the fundamental infrastructure that supports immunization programs throughout the United States, including growing financial burdens and operational complexities in immunization services, shortcomings in public- and private-sector investments in vaccine purchases and immunization programs, and fluctuations in insurance plans in the public and private health care sectors that create uncertainties regarding coverage of vaccine purchase and service delivery arrangements. In October 2001, a group of about 50 health officials, public health experts, health care providers, health plan representatives and purchasers, state legislative officials, and community leaders met at the Texas Medical Association in Austin to explore the implications of the IOM findings and recommendations for Texas. The 1-day workshop was the second in a series of four meetings organized by IOM with support from the Centers for Disease Control and Prevention to foster informed discussions about challenges for immunization finance and future strategies for strengthening immunization activities and the public health infrastructure that supports those activities.This report of the Austin workshop summarizes the findings of the previous IOM report and reviews continuing challenges in immunization finance for the nation and for individual states, with a particular focus on Texas. The report also highlights strategies proposed by individual workshop participants that can be used to address those challenges. Several presenters and discussants emphasized that adequate funding is necessary for immunization programs but that financial resources alone are not sufficient to guarantee success. Similarly, they indicated that no single agency or group in the public or the private sector should expect, or should be expected, to solve immunization problems. Speakers from both public and private health agencies observed that collaboration, consultation, and partnership efforts across levels of government and between the public and private sectors are essential. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Laurene Graig A2 - Elaine Soohoo A2 - Joe Alper TI - Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop SN - DO - 10.17226/25071 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25071/financing-and-payment-strategies-to-support-high-quality-care-for-people-with-serious-illness PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Millions of people in the United States live with serious illnesses such as cancer, heart disease, chronic obstructive pulmonary disorder (COPD), amyotrophic lateral sclerosis, Parkinson’s disease, and dementia—often for many years. Those facing serious illness have a range of interconnected medical and non-medical needs, and the way their care is financed has a large impact on the care they receive. Medicare is the predominant payer, but both Medicaid and private payers also play significant roles in financing care for serious illness. In an effort to address the complex needs of people with serious illness, public and private health care payers are testing innovative financing strategies and alternative payment models. These innovative approaches signal a gradual transition from the traditional-fee-for-service system that pays providers based on the quantity of services to a system based on the value of care provided and a heightened focus on improved quality of care at lower cost. To explore this evolving financing and payment landscape for serious illness care within public- and private-sector programs, the Roundtable on Quality Care for People with Serious Illness developed a workshop, Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness. The workshop convened clinicians, researchers, policy analysts, and patient advocates, as well as representatives from academia, government and private health care plans, and insurers to discuss challenges and opportunities in financing high-quality care for people with serious illness. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - Institute of Medicine TI - Setting the Course: A Strategic Vision for Immunization: Part 3: Summary of the Los Angeles Workshop SN - DO - 10.17226/10607 PY - 2003 UR - https://nap.nationalacademies.org/catalog/10607/setting-the-course-a-strategic-vision-for-immunization-part-3 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Immunization is essential to disease prevention efforts in public health, but the nation's immunization system faces financing challenges that are affecting the delivery of services. A 2000 report from the Institute of Medicine (IOM), Calling the Shots: Immunization Finance Policies and Practices (IOM, 2000), pointed to the instability of the fundamental infrastructure that supports immunization programs throughout the United States, including unpredictable federal funding levels, growing financial burdens and operational complexities in immunization services, shortcomings in public- and private-sector investments in vaccine purchases and immunization programs, and fluctuations in coverage plans in the public and private health care sectors that create uncertainties regarding vaccine purchase and service delivery arrangements. In January 2002, health officials, public health experts, health care providers, health plan representatives, health care purchasers, and community leaders met at the University of California at Los Angeles to explore the implications of the IOM findings and recommendations for California in general and for Los Angeles and San Diego County in particular. The one-day workshop was the third in a series of four meetings organized by IOM with support from the Centers for Disease Control and Prevention to foster informed discussions about challenges for immunization finance and future financing strategies for immunization activities and the public health infrastructure that supports those activities.This report of the Los Angeles workshop summarizes the findings of the IOM study, reviews progress in responding to the IOM recommendations at the federal level, and highlights continuing challenges in immunization finance for the nation and at the state and local levels in California. ER - TY - BOOK AU - Institute of Medicine TI - Improving the Quality of Health Care for Mental and Substance-Use Conditions SN - DO - 10.17226/11470 PY - 2006 UR - https://nap.nationalacademies.org/catalog/11470/improving-the-quality-of-health-care-for-mental-and-substance-use-conditions PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are serious—for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substance–use conditions will benefit from this guide to achieving better care. ER - TY - BOOK AU - Institute of Medicine A2 - Samantha Chao TI - Advancing Quality Improvement Research: Challenges and Opportunities: Workshop Summary SN - DO - 10.17226/11884 PY - 2007 UR - https://nap.nationalacademies.org/catalog/11884/advancing-quality-improvement-research-challenges-and-opportunities-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The Institute of Medicine's Forum on the Science of Health Care Quality Improvement and Implementation held a workshop on January 16, 2007, in Washington, DC. The workshop had its roots in an earlier forum meeting when forum members discussed what is meant by the terms "quality improvement" and "implementation science" and became convinced that they mean different things to different people. At the time, the members also discussed the need to identify barriers to quality improvement research and to implementation science. Thus the purpose of this workshop was to bring people together from various arenas to discuss what quality improvement is, and what barriers exist in the health care industry to quality improvement and also to research about quality improvement. The summary that ensues is thus limited to the presentations and discussions during the workshop itself. We realize that there is a broader scope of issues pertaining to this subject area but are unable to address them in this summary document. The workshop's first session was devoted to experiences that various institutions have had with quality improvement. Recognizing the wealth of experiences available outside of health care services, the workshop included presenters from outside the health care service industry as well as from inside. This includes discussions from a variety of perspectives: non-health care services, health plans, hospitals, and nursing. Advancing Quality Improvement Research: Challenges and opportunities - Workshop Summary describes the events of the workshop. ER - TY - BOOK AU - Institute of Medicine TI - Retooling for an Aging America: Building the Health Care Workforce SN - DO - 10.17226/12089 PY - 2008 UR - https://nap.nationalacademies.org/catalog/12089/retooling-for-an-aging-america-building-the-health-care-workforce PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Industry and Labor AB - As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs. ER -