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Improved Outcomes through Better Out-Patient Care [January 31, 2007] Long-Term Federal Budget Picture Is Grim [January 30, 2007] NIH To Assist Women In Science And Medicine To Fulfill Their Potential [January 29, 2007] Poverty And Its Impact On Health Status [January 26, 2007] Physical Activity Among Adults [January 25, 2007] Rand Study Addresses Current Health Care Reform Debate [January 24, 2007] NIH To Host Workshops To Improve Review Of Grant Applications [January 23, 2007] Allied Health Classroom Seats Go Unfilled [January 22, 2007] Older Americans And The Use Of Complementary And Alternative Medicine [January 19, 2007] Slowdown In National Health Spending [January 18, 2007] Call For Comments On Dental Hygiene Education Program Standards [January 17, 2007] Long-Term Federal Budget Outlook [January 16, 2007] 2006 National Healthcare Disparities Report [January 15, 2007] 2006 National Healthcare Quality Report [January 12, 2007] Allied Health Reinvestment Act To Be Reintroduced [January 9, 2007] Childhood Obesity: Factors Affecting Physical Activity [January 5, 2007] Allied Health Research Institute Launched [January 4, 2007] Financing Community Health Worker Programs [January 3, 2007] Toward More Effective Use Of Research In State Policymaking [January 2, 2007] Wage And Vacancy Survey Of Medical Laboratories [December 29, 2006] Postsecondary Institutions In the United States: IPEDS Data 2005 [December 28, 2006] Comments Sought On National Patient Safety Goals [December 27, 2006] Healthcare Industry Report—2006 [December 26, 2006] Census Bureau's 2007 Statistical Abstract On Health [December 22, 2006] Policy Agenda To Expand The Health Workforce [December 21, 2006] Companies Support Administrative Initiative To Improve Health Care Quality And Reduce Costs [December 20, 2006] The Rise And Fall Of The Oregon Plan [December 19, 2006] Report Of The New Commission On the Skills Of The American Workforce [December 18, 2006] Campaign Launched To Reduce Medical Harm In U.S. Hospitals [December 15, 2006] Medicare Outpatient Therapy Cap Exceptions Process Extended [December 14, 2006] Health Care Finance Outlook [December 13, 2006] Is The U.S. Ready Or Not To Protect The Public From Diseases, Disasters, And Bioterrorism [December 12, 2006] HHS Advances Nationwide Health Information Network Initiative [December 11, 2006] Math And Science And U.S. Competitiveness: Does The Public Care [December 8, 2006] Disability Among Older Americans Continues Significant Decline [December 7, 2006] Geographical Profile Of The Frontline Health Care Workforce [December 6, 2006] Physician Supply And Demand: Projections to 2020 [December 5, 2006] Americans' Views Of Health Care Costs, Access, And Quality [December 4, 2006] The Uninsured And Affordability Of Health Insurance [December 4, 2006] Improved Outcomes through Better Out-Patient Care Chronically ill patients who receive outpatient care that follows prescribed treatment guidelines have better health outcomes over time, according to a study released today by the RAND Corp. and the University of California, Los Angeles. Researchers evaluated the care received by 963 adults from three western states who had heart disease, asthma, emphysema, or diabetes against 120 measures of medical care developed from previous studies and by health experts. Patients whose care most closely followed prescribed treatment guidelines were more likely to maintain good health over the two-and-half year study period and reported better health-related quality of life. The strong relationship between burden of illness and care processes “should stimulate efforts to improve the quality of care for patients regardless of whether they are acutely or chronically ill,” the authors said. The study appears in the February edition of the journal Health Services Research . Long-Term Federal Budget Picture Is Grim A new set of long-term budget projections issued by the Center on Budget and Policy Priorities — the first projections to incorporate the new ten-year estimates issued last week by the Congressional Budget Office — show that the nation's long-term fiscal situation is grim. They also shed light on the sources of these problems and on the types of changes that would be needed to address them. The national debt, now 37 percent of the size of the U.S. economy, will soar to more than two times higher by 2050 if current budget policies are continued (e.g., laws governing entitlement programs are not changed and the Administration's tax cuts are extended). At that point, interest payments alone would soak up more than half of federal revenues. The Center's analysis explains that the main sources of rising government expenditures are cost increases throughout the health care system and, to a lesser degree, demographic changes. Together, these two forces will cause the “big three” entitlement programs — Medicare, Social Security, and Medicaid — to grow considerably faster than the economy or federal revenues. Addressing the nation's fiscal problems will require fundamental health care reform because cost growth in Medicare and Medicaid is largely driven by cost growth in the health care system as a whole, both public and private. Trying to slow health care costs in the public sector without addressing costs in the private sector would require draconian cuts in Medicare and Medicaid that would have severe effects on the poor, the aged, and those with serious disabilities, the Center's analysis finds. NIH To Assist Women In Science And Medicine To Fulfill Their Potential NIH Director Elias A. Zerhouni has created the Working Group on Women in Biomedical Careers to examine issues raised in the recent National Academies report, "Beyond Bias and Barriers, Fulfilling the Potential of Women in Academic Science and Engineering," and to respond to the challenges issued to government funding agencies to maximize the potential of women scientists and engineers. Zerhouni and Vivian Pinn, Associate Director for Research on Women's Health and Director of the Office of Research on Women's Health, will be co-chairpersons of the Working Group. The Office of Research on Women's Health (ORWH), Office of the Director, National Institutes of Health (NIH) serves as the focal point for women's health research at the NIH. For more information about NIH's Office of Research on Women's Health or the Working Group on Women in Biomedical Careers, click http://orwh.od.nih.gov/ or http://orwh.od.nih.gov/careers/careerdev.html . Poverty And Its Impact On Health Status In 2005, 37 million individuals, approximately 13 percent of the total population, lived below the poverty line, as defined by the Census Bureau. To understand better the potential range of effects of poverty, the Government Accountability Office (the investigative arm of Congress), GAO, was asked to examine (1) what the economic research indicates about the relationship between poverty and adverse social conditions such as poor health outcomes. To answer these questions, GAO reviewed the economic literature by academic experts, think tanks, and government agencies, and reviewed additional literature by searching various databases for peer- reviewed economic journals, specialty journals, and books. Economic research suggests that individuals living in poverty face an increased risk of adverse outcomes such as poor health and criminal activity, both of which may lead to reduced participation in the labor market. While the mechanisms by which poverty affects health are complex, some research suggests that adverse health outcomes can be due, in part, to limited access to health care as well as greater exposure to environmental hazards and engaging in risky behaviors. For example, some research has shown that increased availability of health insurance such as Medicaid for low-income mothers led to a decrease in infant mortality. Additionally, exposure to higher levels of air pollution from living in urban areas close to highways can lead to acute health conditions. Data suggest that engaging in risky behaviors such as tobacco and alcohol use, a sedentary life-style, and a low consumption of nutritional foods, can account for some health disparities between lower and upper income groups. The GAO report may be accessed by clicking http://www.gao.gov/new.items/d07343t.pdf . Physical Activity Among Adults The positive influence that physical activity has on health has been well established. Among adults, regular physical activity has been associated with a reduced risk of stroke, impaired glucose tolerance, Type 2 diabetes, mortality, and cardiovascular disease incident events. Engaging in physical activity daily has also proven to be helpful in both losing weight and maintaining weight loss. This report compares national estimates of physical activity, both usual daily activity and leisure-time physical activity, among adults based on responses to the physical activity questions found in the 2000 and 2005 National Health Interview Surveys (NHIS). For more information, click Rand Study Addresses Current Health Care Reform Debate A research brief summarizes the main findings of the RAND Health Insurance Experiment and clarifies its relevance for today's health care debate. The brief may be accessed by clicking NIH To Host Workshops To Improve Review Of Grant Applications Starting in March 2007, the Center for Scientific Review (CSR) at the National Institutes of Health (NIH) will convene the first of six one-day Open House Workshops in 2007 to solicit input from leaders of the scientific community and other stakeholders. This input will be critical to realigning and reinventing CSR's application review groups so the $20+ billion NIH invests in biomedical research grants each year advances the most promising research. Convening the Open Houses represents a systematic effort to engage stakeholders from all the many scientific disciplines to ensure their voices are heard and CSR's review groups are properly aligned and prepared for the future. Those interested in attending are asked to submit a registration form at least three weeks prior to the workshop. The first Open House Workshop will focus on the alignment of CSR's neuroscience study sections. It will be held on Friday, March 2, 2007, from 8:30 a.m. to 4:30 p.m., at NIH's Natcher Conference Center in Bethesda. Five additional Open House Workshops will be convened every other month during 2007 to assess additional groups of CSR study sections: behavioral and social sciences study sections, disease-based study sections, integrated biological study sections (two workshops), and biomolecular study sections. Additional information on these workshops as well as registration forms are available via CSR's Web site: http://www.csr.nih.gov/openhouse or by contacting the Open House Project Coordinator at openhouse@csr.nih.gov or 301-435-1114. Allied Health Classroom Seats Go Unfilled The results of our Association's 2006 Institutional Profile Survey , which was completed in November, became available recently. Based on responses from 87 member institutions, the data show that for the 7 th consecutive year, enrollment capacity has not been reached in several allied health programs. For classes beginning in the fall of that year, programs in 17 of 19 different professions collectively experienced unfilled classroom seats. In 13 of these professions, the deficit was in double digits ranging from a high of 55% in dietetics to a low of 13% in cardiovascular perfusion technology, diagnostic medical sonography, and occupational therapy. Other professions displaying under-enrollment were health administration (54%), rehabilitation counseling (49%), health information management (43%), speech language pathology & audiology (38%), emergency medical sciences (33%), nuclear medicine technology (26%), clinical laboratory sciences/medical technology (25%), and cytotechnology (20%). Given the situation of existing workforce shortages among many of these professions, coupled with the aging of the population, it is not in the best interests of the nation to have thousands of classroom seats in the allied health sciences go unoccupied. ASAHP is working with staff on Capitol Hill to have legislation introduced in the 110 th Congress as a means of addressing allied health workforce problems. Older Americans And The Use Of Complementary And Alternative Medicine In the spring of 2006, AARP and the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health formed a partnership to measure CAM use among older Americans and to understand communication practices between patients and their physicians. A recent report describes the findings of this investigation. Individuals between the ages of 50 and 59 are the most likely to report CAM use. While 63 percent of the 1,559 age 50+ individuals surveyed have used one or more CAM therapies, 69 percent of those who reported using CAM had not discussed it with a physician because the physician never asked (42%), they did not know they should (30%), or there was not enough time during the office visit (19%). Additional barriers include patient perceptions that physicians are unwilling to discuss CAM therapies or will react negatively to disclosure of CAM use. The report may be accessed by clicking http://assets.aarp.org/rgcenter/health/cam_2007.pdf . Slowdown In National Health Spending According to an article in the January-February 2007 issue of Health Affairs , the rate of growth in U.S. health care spending slowed for the third straight year in 2005. Spending increased to 6.9% to almost $2 trillion or $6,697 per person, marking the slowest growth rate since 1999 when enrollment in more tightly managed care plans peaked. Public spending for health (particularly Medicaid) accelerates during recessionary periods. This counter-recessionary trend, combined with the labor-intensive nature of the health care industry, creates health care jobs when employment in other industries is declining. Employment in private health care establishments experienced strong growth in 2001 and peaked in 2002, during and just after the most recent economic recession while employment in other private establishments declined in recent years. The slight slowdown in overall health spending growth in 2005 was driven largely by weaker growth in prescription drug spending; 5.8% compared with 8.6% in 2004. In contrast, hospital spending continued to grow relatively quickly at 7.9 percent in both 2004 and 2005 and accounted for the largest share of the overall spending increase in both years. Call For Comments On Dental Hygiene Education Program Standards The American Dental Association (ADA) Commission on Dental Accreditation (CODA) invites communities of interest to review and comment on the proposed revisions to the Accreditation Standards for Dental Hygiene Education Programs. The American Dental Hygienists' Association (ADHA) Council on Education is considering the proposed revisions to the Accreditation Standards and will provide written comments on behalf of ADHA to CODA. The Council is requesting comments in order to ensure they are representative of the views of the ADHA membership and they should be sent no later than Friday-April 6, 2007 by e-mail to education@adha.net , by FAX to 312-467-1806, or by regular mail to Division of Education, ADHA, 444 North Michigan Avenue, Suite 3400, Chicago, IL 60611. The Standards may be accessed by clicking Long-Term Federal Budget Outlook Testimony, given by David M. Walker, Comptroller General of the United States before the Senate Committee on the Budget, addresses the nation's long-term fiscal outlook and the challenge it presents. The outlook is not good. Continuing down this current fiscal path would gradually erode, if not suddenly damage, out economy, our standard of living, and ultimately even our domestic tranquility and national security. The five major points of the testimony are: (1) The current fiscal condition is worse than advertised, (2) the long-term fiscal outlook is both imprudent and unsustainable, (3) improvements in information and processes are needed and can help, (4) meeting out long-term fiscal challenge will require tough choices, bi-partisan cooperation, and compromise, and lastly (5) the time for action is now. The testimony may be accessed by clicking http://www.gao.gov/new.items/d07342t.pdf . 2006 National Healthcare Disparities Report The 2006 National Healthcare Disparities Report uses the same measures of quality as its companion National Healthcare Quality Report (NHQR) to monitor the Nation's annual progress toward eliminating disparities in health care. Racial/ethnic group comparisons focus on 22 core measures and income group comparisons focus on 17 core measures of quality that support reliable estimates for all groups. Six core measures of access to care are also presented. The report presents, in chart format, the latest available findings on quality of and access to health care in the general U.S. population and among priority populations. It focuses on four components of quality—effectiveness, patient safety, timeliness, and patient centeredness—and two components of access—facilitators and barriers to health care and health care utilization. The report may be accessed by clicking http://www.ahrq.gov/qual/nhdr06/nhdr06report.pdf . 2006 National Healthcare Quality Report The 2006 National Healthcare Quality Report includes 211 performance measures that can be used to monitor the Nation's progress toward improved health care quality for all Americans. This year's report focuses on a group of 42 "core" measures representing the most important and scientifically sound measures of quality. The report presents, in chart format, the latest available findings on the quality of health care in the general U.S. population, focusing on effectiveness, patient safety, timeliness, and patient centeredness. The document may be accessed by clicking http://www.ahrq.gov/qual/nhqr06/nhqr06report.pdf . Allied Health Reinvestment Act To Be Reintroduced Childhood Obesity: Factors Affecting Physical Activity Allied Health Research Institute Launched What started out as a “think tank” type project has become a non-profit organization aimed at helping alleviate the allied health workforce shortage and providing critical data for developing best practice patterns for the industry. The FuturePoint Summit , which originated at the University of Missouri-Columbia School of Health Professions, is now officially The Allied Health Research Institute (AHRI). Richard Oliver , Dean of the MU School of Health Professions, has been elected president of the AHRI. He calls the institute an organization comprised of academia, employers, and other members who have a common goal of filling the allied health professions with qualified professionals as well as developing better, more efficient models of care. The AHRI board of directors also includes Susan Hanrahan , Dean of the College of Nursing and Health Professions at Arkansas State University, and James Erdman , Dean of the College of Health Professions at Thomas Jefferson University. The principal objectives of AHRI are to: • Create a central data repository to collect and analyze clinical outcomes for the purpose of establishing industry and academic-supported, evidence-based practice patterns. • Promote awareness and advocacy of public and private sector policies that support growth and more efficient, effective and higher quality standards of care. • Advance education and training to better integrate curriculum and accreditation requirements with the needs of patients and employers. Financing Community Health Worker Programs Interest is growing in the use of community health workers in various roles in the US health care system. These workers go by various titles and names - including promotores and community health advisors - but all play an essential paraprofessional role in assisting members of the communities they serve. Their activities at different times involve education, problem-solving, direct assistance, advocacy, and organization. As the role of these workers becomes more accepted and desirable in the overall system of care, they face the challenges of moving from being an exceptional add-on to the system to being more a part of the main stream. Issues such as educational preparation, formal credentialing, licensure and compensation are all part of this process. In particular, various organizations are interested in but challenged by the need for sustainable financing of the CHW position. Viable finance arrangements that go beyond short-term grant funds must be explored and developed. To address this issue, the National Fund for Medical Education and staff at the UCSF Center for the Health Professions studied existing and emerging funding, reimbursement, and payment policies for community health workers. Research findings include several sustainable financing models and practices in place. For additional information, click http://futurehealth.ucsf.edu/pdf_files/CHW%202006.pdf to obtain a copy of a report. Toward More Effective Use Of Research In State Policymaking Health services research can be used to inform policymakers about pressing issues; provide them with data and resources needed to develop new programs or reform existing ones; guide the implementation process; and evaluate programs or policies to determine whether they are meeting their goals. Yet, putting new and innovative research to work in the policymaking process takes tenacity and understanding on the part of both researchers and policymakers. Effective partnerships between researchers and policymakers are grounded in sustainable relationships and mutual trust. A new report from The Commonwealth Fund sets out a conceptual framework to support effective use of research in health policymaking and improve communications between researchers and state policymakers and program administrators. The report may be accessed by clicking Wage And Vacancy Survey Of Medical Laboratories Nearly 44% of laboratories report that they currently are experiencing difficulties in recruiting or hiring medical laboratory personnel. The results of the survey by the American Society for Clinical Pathology (ASCP) are described in the August 2006 issue of LABMEDICINE. To attract recruits, laboratories were most likely to offer larger salaries, reimburse educational costs, or offer sign-on bonuses. Another popular strategy for coping with staffing shortages was the use of per diem or temporary staff. Training programs struggle to attract talented students to the professions and the challenge of having an adequate laboratory workforce is compounded by the impending retirement of the baby boomer generation. Postsecondary Institutions In the United States: IPEDS Data 2005 This First Look presents findings from the Integrated Postsecondary Education Data System (IPEDS) fall 2005 data collection, which included two survey components: Institutional Characteristics for the 2005-06 academic year, and Completions covering the period July 1, 2004, through June 30, 2005. These data were collected through the IPEDS web-based data collection system. The report may be accessed by clicking http://nces.ed.gov/pubs2007/2007167.pdf . Comments Sought On National Patient Safety Goals The Joint Commission on Accreditation of Healthcare Organizations has released for review a list of DRAFT Goals and Requirements that will be considered for potential inclusion in the 2008 National Patient Safety Goals. The Goals, which are updated annually, are designed to require health care organizations to protect patients from the negative impact of specific health care errors. The draft Goals include requiring organizations to:
The deadline for feedback is Friday, January 26, 2007 . Healthcare Industry Report—2006 KPMG's Healthcare Industry Report--2006 offers information about the current state of the U.S. healthcare industry, recent history, and challenges ahead. We review health status, healthcare quality, and national health expenditures, and offer perspectives and statistics on various components of the healthcare system. The report may be accessed by clicking Census Bureau's 2007 Statistical Abstract On Health The U.S. Census Bureau recently published its 2007 Statistical Abstract . The health and nutrition s ection presents data on health expenditures and insurance coverage, including Medicare and Medicaid, medical personnel, hospitals, nursing homes and other care facilities, injuries, diseases, disability status, nutritional intake of the population, and food consumption. The data may be accessed by clicking http://www.census.gov/prod/2006pubs/07statab/health.pdf . Policy Agenda To Expand The Health Workforce Leaders of major national health professions education and practice organizations recommended ways to increase the capacity of the nation's health workforce during an Association of Academic Health Centers (AAHC) sponsored event on public policy and the health workforce. Representing pharmacy, dentistry and dental hygiene, nursing, medicine, allied health, and public health, association leaders and policy experts identified barriers to increasing the capacity as well as avenues for change and improvement in policymaking related to the workforce. The policy agendas highlighted the piecemeal approach to policymaking and the need for strategic national direction. The AAHC is addressing the implications of the health workforce crisis and assessing options to develop and protect the nation's health workforce. This major initiative is funded in part by the Josiah Macy, Jr., Foundation. For additional information, click http://www.aahcdc.org/policy/workforce.php . Companies Support Administrative Initiative To Improve Health Care Quality And Reduce Costs More than 100 employers have committed in the past month to goals that will improve health care quality and lower costs for employees and their families, HHS Secretary Mike Leavitt announced today. Since his call to action at a November 17th summit of hundreds of business leaders, companies like General Motors, Ford Motor Company, DaimlerChrysler, IBM, Xerox, Starbucks, Aetna, Humana Inc., General Mills and Dow Chemical Company have all joined. In addition, the Commonwealth of Virginia recently became the latest state to express support for the initiative. Other states like Georgia and Texas have taken significant steps to promote value driven health care. Fundamental information about health care quality and costs of services is largely unavailable today to consumers, to payers, and to providers alike. Without this information, it is difficult to make informed choices and seek out the best quality at the most affordable price. This contributes to higher health care costs overall. Last August, President Bush signed an executive order committing federal health care programs to the four "cornerstone" goals. Medicare, the Veterans Affairs health system, the Federal Employees Health Benefit Program and certain other federal health care programs will begin delivering on the four goals in the coming year. Employers are the largest source of health coverage for Americans. If a significant number of employers also commit to the four goals, common standards for health IT, quality measurement and cost reporting would quickly become the standard throughout the health care system. Secretary Leavitt called on employers to make a similar commitment to these four goals, including: More information is accessible by clicking www.hhs.gov/transparency. The Rise And Fall Of The Oregon Plan What went wrong with the Oregon Health Plan and what does it say about the prospects for coverage expansion initiatives in other states? Those are the questions addressed by Jonathan Oberlander in a Health Affairs Web Exclusive published today. When it was first enacted in 1989 and approved by the federal government as a Section 1115 Medicaid demonstration project in 1993, the OHP represented a leading state policy innovation that sparked a national debate on rationing health care. OHP was “intended to expand Medicaid to more people by covering fewer services,” says Oberlander. But now the plan is “covering both fewer services and fewer people, and the elimination of entire benefit categories and rollback in enrolled beneficiaries looks more like the arbitrary cuts common in other states than the rational and equitable model of prioritization to which Oregon aspired.” The article can be accessed by clicking Report Of The New Commission On the Skills Of The American Workforce The New Commission on the Skills of the American Workforce report, Tough Choices or Tough Times , offers a number of recommendations, including transforming teacher recruitment and training as well as rewarding institutions that graduate high-performing teachers. Another proposal—modeled on the European system—would test high school students at age 16 and then allow students who meet the minimum test standards to enroll in a community college program for either a two-year technical degree or a program that would transition to a degree at a four-year institution. Higher-scoring students would remain in high school and prepare for a more rigorous test that would allow them to graduate with enough credits to enter college as juniors. The Executive Summary may be accessed by clicking Campaign Launched To Reduce Medical Harm In U.S. Hospitals The Institute for Healthcare Improvement (IHI) announced, with the support of prominent leaders in American health care, a national campaign to reduce incidents of medical harm in U.S. hospitals dramatically. The 5 Million Lives Campaign will ask hospitals to improve more rapidly than before the care they provide in order to protect patients from five million incidents of medical harm over a 24-month period, ending December 9, 2008. The effort represents a continuation of the largest improvement effort undertaken in recent history by the health care industry. The new Campaign – which will be sponsored principally by America's Blue Cross and Blue Shield health plans – builds upon the success of the 100,000 Lives Campaign, in which 3,100 participating hospitals reduced inpatient deaths by an estimated 122,000 in 18 months through overall improvement in care, including improvement associated with six interventions recommended by the initiative. The 5 Million Lives Campaign will promote the adoption of 12 improvements in care that can save lives and reduce patient injuries and it aims to enroll even more hospitals than participated in the previous Campaign. For additional information, click Medicare Outpatient Therapy Cap Exceptions Process Extended Prior to adjourning for the year and the closing of the 2 nd Session of the 109 th Congress, legislation was passed to extend the current exceptions process on the Medicare outpatient therapy cap. The provision was included in H.R. 6111, The Tax Care Relief and Health Care Act of 2006. The extension is in effect until January 1, 2008. Consumer-focused health system changes and a rapidly evolving competitive landscape are key issues for health care finance leaders in 2007, according to a new report from the Healthcare Financial Management Association. Hospitals face an unprecedented level of credit risk as patient co-payments and deductibles rise and revenue cycle improvement and cost containment continue to be top priorities. Other member concerns include consumer-focused practices, payment trends, and business development. The report may be accessed by clicking Is The U.S. Ready Or Not To Protect The Public From Diseases, Disasters, And Bioterrorism Trust for America's Health (TFAH) today released the fourth annual “Ready or Not? Protecting the Public's Health from Disease, Disasters, and Bioterrorism,” which found that, five years after the September 11 th and anthrax tragedies, emergency health preparedness is still inadequate in America. The “Ready or Not?” report contains state-by-state health preparedness scores based on 10 key indicators to assess health emergency preparedness capabilities. All 50 U.S. states and the District of Columbia were evaluated. Half of states scored six or less on the scale of 10 indicators. Kansas and Oklahoma scored the highest with nine out of 10; California, Iowa, Maryland, and New Jersey scored the lowest with four out of 10. The federal government currently does not consistently, objectively measure or provide state-by-state information to help Americans and policymakers assess how prepared their communities are to respond to health threats. The report may be accessed by clicking HHS Advances Nationwide Health Information Network Initiative Staff at the HHS Office of the National Coordinator for Health Information Technology will support trial implementations for the Nationwide Health Information Network (NHIN). Trial implementations of the NHIN are a key step toward meeting the President's vision of using information technology to make patient information available to providers and consumers, regardless of geographic location. In coming months, details of the procurement process for the trial implementations will be announced. Proposals to create the trial implementations and work toward integrating them with the broader NHIN initiative will be solicited in spring 2007. This last year's NHIN activities included “prototype architectures” developed by four consortia of health care and health information technology organizations through contracts with HHS. This “prototype architecture” work included developing functional requirements, security approaches, and identifying needed standards for creating secure health information exchange in different health care markets. In January 2007, the four existing consortia will present the prototype architectures at the American Health Information Community and the third NHIN forum to be held in Washington, D.C. A summary report capturing key findings from this past year will be published in early 2007. More information about the HHS health information technology initiative can be accessed by clicking Math And Science And U.S. Competitiveness: Does The Public Care Eighty-five percent of Americans view cheap labor rather than the development of a more skilled workforce overseas as the most significant threat to U.S. competitiveness, according to the results of a poll commissioned by Solutions for Our Future and released recently. While policy makers and opinion leaders in the United States recently have paid significant attention to maintaining America's competitive advantage in the global economy and have proposed meeting the challenges by focusing on enhancing human capital in the Science, Technology, Engineering and Mathematics (STEM) fields, the public has a different view of the challenge and the potential solutions. Less than one-third of the public (31 percent) believe that math and science classes offered to students not majoring in those fields are "very relevant" to life after graduation. In addition, only a slight majority of the public (54 percent) believe that all students should have to take more math and science courses. The American Council on Education manages the Solutions for Our Future campaign for a coalition of colleges, universities and community and business partners. A summary report may be accessed by clicking Disability Among Older Americans Continues Significant Decline Chronic disability among older Americans has dropped dramatically and the rate of decline has accelerated during the past two decades, according to a new analysis of data from the National Long-Term Care Survey (NLTCS). The study, published in the Proceedings of the National Academy of Sciences , found that the prevalence of chronic disability among persons 65 and older fell from 26.5 percent in 1982 to 19 percent in 2004/2005. The findings suggest that older Americans' health and function continue to improve at a critical time in the aging of the population. In addition to a drop in the percentage of older Americans reporting disability, the analysis found that the average annual rate of the decline has accelerated. The decline in disability averaged 1.52 percent annually over the 22-year time span, but the rate of change shifted gradually from 0.6 percent in 1984 to 2.2 percent in 2004/2005. The paper appears in the November 28, 2006, print edition of PNAS and can be accessed by clicking: Geographical Profile Of The Frontline Health Care Workforce The frontline workforce is a diverse group of professionals and paraprofessionals who provide a range of direct patient care and client services. The Robert Wood Johnson Foundation believes this fast-growing segment of the health and health care workforce, a group that plays a critical role in ensuring delivery of high quality care and services, warrants further research and outreach. This frontline workforce is growing rapidly; collectively it is growing faster (32.6%) than the growth rate of all health and health care occupations (28.3%), and significantly faster than the growth rate for all occupations (14.8%) in the United States workforce (Bureau of Labor Statistics Occupational Employment Statistics, 2003). This segment of the health workforce will continue to play a critically important role within public health and the health care delivery system, but little has been known about who these workers are and what employment issues and needs they face. A new248-page chartbook attempts to fill this research gap by providing information about frontline occupations on both national and state levels. The chartbook may be accessed by clicking Physician Supply And Demand: Projections to 2020 Debates continue in the United States about the adequacy of the current and future supply of physicians. While the general consensus is that overall physician supply per capita will remain relatively stable over the next 15 years, there is less agreement on future demand for physician services. A paper from the Health Resources and Services Administration (HRSA) presents projections of physician supply and requirements for 18 physician specialties using the Physician Supply Model (PSM) and the Physician Requirements Model (PRM) developed by HRSA. It describes the data, assumptions, and methods used to project the future supply of and requirements for physician services, contains projections from these models under alternative scenarios, and includes a discussion of implications of these projections for the future adequacy of physician supply. The paper may be accessed by clicking Americans' Views Of Health Care Costs, Access, And Quality According to a recent article in The Milbank Quarterly , for more than two decades, polls have shown that Americans are dissatisfied with their current health care system. However, the public's views on how to change the current system are more conflicted than often suggested by individual poll results. At the same time, Americans are both dissatisfied with the current health care system and relatively satisfied with their own health care arrangements. As a result of the conflict between these views and the public's distrust of government, there often is a wide gap between the public's support for a set of principles concerning what needs to be done about the overall problems facing the nation's health care system and their support for specific policies designed to achieve those goals. The article may be accessed by clicking The Uninsured And Affordability Of Health Insurance Nearly 25 million uninsured Americans may not earn enough to purchase health insurance, but are ineligible for public coverage, according to a study published recently by Health Affairs . Another 11 million uninsured residents may be eligible for public programs and nearly 9 million may be able to afford coverage, the study estimates. The authors estimate that one-quarter of the nation's 44.6 million uninsured residents may be eligible for public programs, 56% may need financial assistance to purchase health insurance, and 20% may be able to afford coverage, based on the 2005 Current Population Survey. The publication may be accessed by clicking
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