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Youth Indicators, 2005: Trends in the Well-Being of American Youth [July, 29, 2005] Aging Trends [July 28, 2005] CMS Quality Improvement Roadmap [July 27, 2005] Symposium On Strategies To Transform Health Professional Education [July 26, 2005] Building A Better Health Care Delivery System [July 25, 2005] America's Children: Key National Indicators Of Well-Being 2005 [July 22, 2005] Medicare Chartbook 2005 [July 21, 2005] IOM Workshop Summary Of The Contributions Of Lifestyle Factors To Preventable Death [July 20, 2005] House Education Committee Scheduled To Vote On HEA Reauthorization Bill On July 20 [July 19, 2005] Senate Appropriations Committee Restores Funding For Health Professions Education Programs [July 18, 2005] Despite Conflicting Studies About Obesity, Most Americans Think The Problem Remains Serious [July 15, 2005] AHRQ Research Findings Available [July 14, 2005] Health Spending In The U.S. And The World [July 13, 2005] Higher Education Act Moves Forward In U.S. House [July 12, 2005] High-Cost Medicare Beneficiaries [July 11, 2005] State Education Data Profiles [July 8, 2005] Keynote Address On The Imperfection Of Medicine [July 7, 2005] Influenza Pandemic: Challenges In Preparedness And Response [July 6, 2005] Model Of Patients' Choices Of Hospital [July 5, 2005] Health Insurance Coverage In 2004 [July 1, 2005] Harvard Macy Institute Program For Educators In The Health Professions [June 30, 2005] How Much Students Borrow To Pay For College [June 28, 2005] U.S. House Nixes Allied Health Grants Program [June 27, 2005] Report On Linking Scholarship And Communities [June 24, 2005] Statement On Academic Rights And Responsibilities [June 23, 2005] Health Policy Fellowships Available [June 22, 2005] Guide To Clinical Preventive Services [June 21, 2005] Bridging The Culture Gap [June 20, 2005] Commonwealth Fund Establishes State Innovations Program [June 17, 2005] Web Site Launched To Disseminate Information About Medical Studies [June 16,2005] 10 Change Drivers That Will Shape Future Public Policy [June 15, 2005] Patients Like E-Mail, But Physicians Prefer The Telephone [June 14, 2005] Conversations On Health With NIH Director Zerhouni [June 13, 2005] Racial/Ethnic Diversity in Health Services Research [June 10, 2005] House Appropriators Gut Health Professions Education Programs [June 9, 2005] Health Informatics Grant Announced [June 8, 2005] Survey Of Dental Hygienists Underway [June 7, 2005] New Steps By HHS To Advance Health Information Technology [June 6, 2005] Estimating The Contributions Of Lifestyle-Related Factors To Preventable Death [June 3, 2005] The Condition Of Education 2005 [June 2, 2005] HHS And Health Information Technology [June 1, 2005] Youth Indicators, 2005: Trends in the Well-Being of American Youth Youth Indicators, a publication of the National Center for Education Statistics (NCES) contains statistics that address important aspects of the lives of youth, including family, schooling, work, community, and health. The report focuses on American youth and young adults 14 to 24 years old and presents trends in various social contexts that may relate to youth education and learning. The document may be accessed by clicking http://nces.ed.gov/pubs2005/2005050.pdf . Persons turning 50 today have about half their adult lives ahead of them. Each year, more than four million men and women join their ranks. What do they have to look forward to? Will they be able to attain the quality of life they want in their later years? In its ongoing Beyond 50 series of annual reports, AARP assesses the state of America's aging population in such vital and significant areas of concern as economic security and health care. The report may be accessed by clicking http://assets.aarp.org/rgcenter/econ/beyond_50_econ.pdf . CMS Quality Improvement Roadmap The Centers for Medicare & Medicaid Services has provided to congressional committees with jurisdiction over Medicare and Medicaid a roadmap for improving the nation's health care quality. The roadmap may be accessed by clicking http://www.cms.hhs.gov/quality/quality%20roadmap.pdf . Symposium On Strategies To Transform Health Professional Education Leaders from health care education, professional associations, licensing and accrediting bodies, health care organizations and the public policy sector will seek solutions identified by the Institute of Medicine (IOM) during a national symposium convened by the Joint Commission on Accreditation of Healthcare Organizations and its affiliate Joint Commission Resources. "Transforming Health Professional Education: Core Competencies, Microsystems and New Training Venues" will be held at the Hyatt Regency O'Hare in suburban Chicago on September 14-15, 2005. Key symposium topics include: • Actions to create widespread changes in established practices and systems • Models of change • Alignment of oversight bodies to support redesigned professional education • Changes in payment and reimbursement policies that may drive change • Measuring changes in health professional education The cost is $695 per person, with discounts available for early registration before August 1. To register, call Tel: 877-223-6866 Building A Better Health Care Delivery System The U.S. health care industry has neglected engineering strategies and technologies that have revolutionized quality, productivity, and performance in many other industries, according to a new report from the National Academies' National Academy of Engineering and Institute of Medicine. This "collective inattention" has contributed to serious consequences in health care -- nearly 100,000 preventable deaths per year, outdated procedures, about a half-trillion dollars wasted annually through inefficiency, costs rising at roughly three times the rate of inflation, and 43 million people uninsured. T he committee that wrote the report stated that h ealth care professionals and engineers should work more closely together to address these challenges. The document may be accessed by clicking http://www.nap.edu/books/030909643X/html/ . America's Children: Key National Indicators Of Well-Being 2005 America's Children: Key National Indicators of Well-Being, 2005 is a biennial report to the Nation on the condition of children in America. Nine contextual measures describe the changing population, family, and environmental context in which children are living and 25 indicators depict the well-being of children in the areas of economic security, health, behavior and social environment, and education. This year's report has special features on children with asthma, children with specified blood lead levels, and parental reports of children's emotional and behavioral difficulties. In addition, the report includes a special section on family structure and the well-being of children. Highlights from each section of the report follow. The report may be accessed by clicking http://childstats.gov/americaschildren/index.asp . The Kaiser Family Foundation has released a new Medicare chartbook for 2005 that examines state-specific data and historical trends. Topics covered in the chartbook include demographic information of Medicare beneficiaries; benefits and utilization; supplemental insurance, Medicare Advantage and Medicaid; out-of-pocket spending; prescription drugs; program spending, including per-beneficiary spending; financing and future projections; and comparative state data, including information on dual eligibles The chartbook may be accessed by clicking http://www.kff.org/medicare/7284.cfm . IOM Workshop Summary Of The Contributions Of Lifestyle Factors To Preventable Death The Institute of Medicine of the National Academies held a workshop on December 13-14, 2004 to estimate the contributions of lifestyle-related factors to preventable death. The event was sponsored by the Centers for Disease Control and Prevention. The workshop's statement of task included these specific questions:
The summary of the workshop may be accessed by clicking http://www.nap.edu/books/0309096901/html . House Education Committee Scheduled To Vote On HEA Reauthorization Bill On July 20 The House Committee on Education and the Workforce will consider the reauthorization of the Higher Education Act, H.R. 609, on July 20. The session will begin at 10:30 AM. The College Access and Opportunity Act, introduced earlier this year by Boehner and 21st Century Competitiveness Subcommittee Chairman Howard P. “Buck” McKeon (R-CA), is comprehensive legislation that establishes the relationship between the federal government and the nation's two-year and four-year, public and private colleges and universities. The legislation also authorizes funding for the multi-billion dollar student aid and student loan programs. The committee's proceedings may be viewed by webcast at http://edworkforce.house.gov/issues/109th/education/hea/hea.htm . Senate Appropriations Committee Restores Funding For Health Professions Education Programs The full Appropriations Committee voted last Thursday afternoon to report the FY 2006 Labor, HHS, Education, and Related Agencies Appropriations bill to the Senate. The bill includes $454.4 million for Health Professions programs. This amount restores funding to these programs that were eliminated in the presidents budget, including the Section 755 Allied Health Grants Program under Title VII of the Public Health Service Act. Bill Highlights : The House already passed its Labor-HHS spending bill, but nearly every Title VII program would be eliminated if that chamber's version stands the test of time. The next step will be for representatives from the House and Senate committees to meet in conference to resolve differences. Despite Conflicting Studies About Obesity, Most Americans Think The Problem Remains Serious The complete survey and power point slides may be accessed by clicking: AHRQ Research Findings Available The June issue of the Research Activities Newsletter of the Agency for Healthcare Research and Quality is available online. Items include: -More than 13 percent of primary care patients do not know why they are taking at least one of their prescription medications. - Herbal use is common among urban primary care patients and often is not disclosed to doctors. - Existing coronary heart disease is undiagnosed in half of women who have a first heart attack. The newsletter may be accessed by clicking http://www.ahcpr.gov/research/jun05/ . Health Spending In The U.S. And The World A study published in Health Affairs, supported by The Commonwealth Fund, finds that higher prices for health services such as prescription drugs, hospital stays, and doctor visits, are the main reason for higher U.S. spending. The latest data from the Organization for Economic Cooperation and Development (OECD), which compare trends among 30 industrialized countries, show that the U.S. spent $5,267 per capita on health care in 2002—53 percent more than any other country. For additional information, click http://www.cmwf.org/usr_doc/846_anderson_hltspendingUS&world_itl.pdf Higher Education Act Moves Forward In U.S. House The Higher Education Act will be addressed this week when the 21st Century Competitiveness Subcommittee in the House of Representatives marks up H.R. 609, the College Access and Opportunity Act of 2005. The subcommittee, led by Rep. Howard “Buck” McKeon (R-CA), will meet Wednesday, July 13, at 10:30 a.m., to consider the legislation and amendments. The Act contains several key reforms to strengthen America's higher education system by expanding college access and restoring the focus of federal aid programs to serve students better. Main issues include accreditation, transfer of credit, college costs, single definition of eligible institutions, and teacher education. High-Cost Medicare Beneficiaries Total Medicare spending exceeded $300 billion in 2004 and is expected to grow significantly in the coming decades. In response to those financial pressures, policymakers have considered a number of strategies for slowing the growth of Medicare spending, including increasing the share of spending paid by beneficiaries and enhancing competition in the provision of services. A Congressional Budget Office (CBO) paper, prepared at the request of the Senate Majority Leader, explores an additional approach: focusing on the small group of beneficiaries that accounts for a large share of the program's spending. Possible intervention strategies would aim to reduce that spending. The paper analyzes the concentration of Medicare spending in a given year and over time using data from Medicare claims and considers illustrative methods for identifying beneficiaries who are likely to incur high future costs. The paper may be accessed by clicking http://www.cbo.gov/showdoc.cfm?index=6332&sequence=0 . The National Center for Education Statistics (NCES) recently made available a set of State Education Data Profiles. Information is provided about all levels of education, public libraries, and selected demographics for all states in the U.S. As many as four states can be selected at a time for comparison purposes. Data on U.S. averages and the ability to graph the results are additional features. The profiles may be accessed by clicking http://nces.ed.gov/programs/stateprofiles/ . Keynote Address On The Imperfection Of Medicine Noted author Dr. Atul Gawande delivered the Keynote Address at AcademyHealth's 2005 Annual Research Meeting in Boston on June 26. His topic was “The Imperfection of Medicine.” He is a surgeon at the Dana Farber Cancer Institute in Boston and writes for The New Yorker. His presentation may be accessed by clicking here. Influenza Pandemic: Challenges In Preparedness And Response Shortages of influenza vaccine in the 2004-05 and previous influenza seasons and mounting concern about recent avian influenza activity in Asia have raised concern about the nation's preparedness to deal with a worldwide influenza epidemic or influenza pandemic. Although the extent of such a pandemic cannot be predicted, according to the Centers for Disease Control and Prevention (CDC), an agency within the Department of Health and Human Services (HHS), it has been estimated that in the absence of any control measures such as vaccination or antiviral drugs, a "medium-level" influenza pandemic could kill up to 207,000 people in the United States, affect from 15 to 35 percent of the U.S. population, and generate associated costs ranging from $71 billion to $167 billion in the United States. The General Accountability Office (GAO), the investigative arm of Congress, was asked to discuss the challenges the nation faces in responding to the threat of an influenza pandemic, including the lessons learned from previous annual influenza seasons that can be applied to its preparedness and overall ability to respond to a pandemic. The agency presented testimony based on GAO reports and testimony issued since 2000 on influenza vaccine supply, pandemic planning, emergency preparedness, emerging infectious diseases, and on current work examining the influenza vaccine shortage in the United States for the 2004-05 influenza season. The testimony may be accessed by clicking http://www.gao.gov/new.items/d05863t.pdf . Model Of Patients' Choices Of Hospital The London Patient Choice Project (LPCP) was established to improve choices for patients who are clinically eligible for treatment and who have been waiting for treatment at an NHS London hospital beyond some target waiting time. As the target waiting time approaches, patients are given an opportunity to choose from a range of alternative providers who have the capacity to offer earlier treatment. The aim of this study is to investigate the following questions regarding patients' responses to the option of quicker treatment: What are the factors that patients consider when deciding whether to accept the alternatives they are offered? What weight do patients place on each factor when making their choices? What tradeoffs are patients prepared to make between time waited and other factors? Are there any systematic differences between sub-groups of patients regarding how they respond to choice? What are the characteristics of those who are more likely to opt for quicker treatment? The report may be accessed by clicking http://www.rand.org/pubs/technical_reports/2005/RAND_TR230.pdf . Health Insurance Coverage In 2004 Based on the National Health Interview Survey, approximately 51.6 million Americans, or 17.9% of the population, were uninsured for at least part of the year in 2004, according to preliminary estimates released June 29 by the Centers for Disease Control and Prevention. The estimates are based on the CDC's, which in 2004 included new questions designed to ensure individuals who say they are uninsured are not in fact covered by Medicare or Medicaid. For additional information, click http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur200506.pdf Harvard Macy Institute Program For Educators In The Health Professions The Harvard Macy Program has an offering to enhance the professional development of physicians, basic scientists, and other healthcare professionals as educators. The program will combine five major themes: learning and teaching, curriculum, evaluation, leadership, and information technology. The program provides a select group of 55 healthcare professionals with the knowledge base and skills to enhance their expertise in both conducting an educational project of their own design and taking a leadership role in the educational activities at their home institutions. The program consists of two sessions in residence at Harvard: an 11-day winter session and an 6-day spring session. Learning formats include large-group presentations, interactive exercises, problem-based learning, observations, reflective use of journals, and discussion in large and small groups. For additional information, click http://www.harvardmacy.org/programs.asp?DocumentID=1 . How Much Students Borrow To Pay For College The percentage of students who borrow to finance their college education has risen considerably since the early 1990s due in large part to legislative changes in eligibility, but a new issue brief by the American Council on Education (ACE) finds that student borrowing levels vary significantly depending on degree program. Federal Student Loan Debt: 1993 to 2004 also highlights certain groups of students-including those who earn associate degrees from for-profit institutions; those who are low-income, independent, bachelor's degree recipients; and many earning professional degrees-who face student loan debt that may present significant financial burden. The report may be obtained by clicking here. U.S. House Nixes Allied Health Grants Program Last Friday, the U.S. House of Representatives approved a $602 billion Labor-HHS-Education fiscal year 2006 appropriations bill (HR 3010) on a vote of 250-151. Among the 57 programs eliminated is the allied health grants program, Section 755 of Title VII of the Public Health Service Act. The House bill eliminates funding for all Title VII programs with the exception of $35 million for Scholarships for Disadvantaged Students (25.5 percent cut below last year) and $12 million or the Centers of Excellence (64 percent cut) and retains level funding for Title VIII nursing. Overall, the legislation would provide $142.5 billion in funds for discretionary spending for FY 2006 -- $164 million less than for FY 2005 and $924 million more than President Bush requested -- with the remainder used to fund mandatory programs such as Medicare and Medicaid. Report On Linking Scholarship And Communities “Linking Scholarship and Communities: The Report of the Commission on Community-Engaged Scholarship in the Health Professions” is available in PDF format. With funding from the WK Kellogg Foundation, Community-Campus Partnerships for Health convened the Commission. The report may be obtained by clicking http://depts.washington.edu/ccph/pdf_files/Commission%20Report%20FINAL.pdf . Statement On Academic Rights And Responsibilities This morning, the American Council on Education (ACE) and a group of 25 higher education associations released a statement regarding the concept of intellectual pluralism as it applies to colleges and universities. The statement may be accessed by clicking here. Health Policy Fellowships Available The National Center for Health Statistics (NCHS) in the Center for Disease Control and Prevention's (CDC), U.S. Department of Health and Human Services (DHHS), and AcademyHealth seek applicants for their 2006 Health Policy Fellowship. This program brings visiting scholars in health-services-research-related disciplines to NCHS to use NCHS data systems and collaborate on studies of interest to policymakers and the health services research community. For more information, click http://www.academyhealth.org/nchs/brochure.pdf . Guide To Clinical Preventive Services The Agency for Healthcare Research and Quality released “ The Guide to Clinical Preventive Services 2005 ,” which highlights current recommendations from the U.S. Preventive Services Task Force. These evidence-based recommendations for clinicians address preventive services, including screening tests, counseling, and preventive medications for adults and children in the primary care setting. The guide includes the Task Force's recommendations on prevention and early detection for cancer; heart and vascular diseases; infectious diseases; injury and violence; mental health conditions and substance abuse; metabolic, nutritional, and endocrine conditions; musculoskeletal conditions; and obstetric and gynecological conditions. The guide may be accessed by clicking http://www.ahcpr.gov/clinic/pocketgd.pdf . A new article entitled “Bridging the Culture Gap” by Carol Levine of the United Hospital Fund of New York recently appeared on the hospitalconnect.com website. Although health care professionals and family caregivers want the same things for a patient, the relationship between them is often strained and sometimes hostile. Part of the tension arises because health care providers and family caregivers have different cultures. The article offers practical steps hospital leaders can take to improve relations between family caregivers and hospital staff. It may be accessed by clicking here. Commonwealth Fund Establishes State Innovations Program Across the nation, states face the common challenges of expanding health coverage, improving the quality of care, and controlling costs. Over the next five years, many states will develop and implement major health system improvements, offering a nation-wide laboratory of experimentation. State and federal policymakers and other stakeholders can tap into this wealth of experience, exchange data and policy strategies, and develop models that can be replicated across the nation. To focus attention on state health policies, the Fund's board of directors recently approved the establishment of a State Innovations program. The first step has been the launch of a quarterly digest of innovative state actions to improve health system performance: “States in Action: A Quarterly Look at Innovations in Health Policy.” The digest may be accessed by clicking: Web Site Launched To Disseminate Information About Medical Studies A consortium of medical-journal publishers and patient-advocacy groups is unveiling a Web site to help consumers navigate the world of health research on the diagnosis and treatment of cancer, heart disease, and diabetes. The site will offer free access to selected medical-journal articles, and provide plain-language explanations of what the studies mean, how they compare with what's already known, and how patients should weigh them in making treatment decisions. The site may be accessed by clicking http://www.patientinform.org/PI/home.jsp 10 Change Drivers That Will Shape Future Public Policy A new report from the Council of State Governments that outlines the major long-term trends shaping U.S. society and their implications for state governments nationwide has been released. "Trends in America: Charting the Course Ahead" describes 10 major change drivers that will influence the direction of public policy in the next five years and beyond. In December, a follow-up report will identify innovative options states should consider to respond to emerging conditions and better anticipate those to come. The report may be accessed by clicking Patients Like E-Mail, But Physicians Prefer The Telephone Patients like having access to their electronic health record (EHR) and communicating with their doctor by E-mail for certain things, but doctors still prefer the telephone to E-mail, according to a recent study that was supported by the Agency for Healthcare Research and Quality. Andrea Hassol, M.S.P.H., of Abt Associates, Inc., and her colleagues conducted an online survey of 4,282 members of the Geisinger Health System, who are registered users of the computer application, MyChart. MyChart allows patients to communicate electronically with their providers and view selected portions of their EHRs. The researchers also conducted focus groups with 25 patients who were using the system and one-on-one interviews with 10 primary care clinicians about patient access to the EHR and use of E mail communication between patients and doctors. The majority of users found the system easy to use (mean scores of 78 to 85 on a 1-100 scale) and reported that their medical record information was complete, accurate, and understandable (mean scores from 65 to 85). Only a minority was concerned about the confidentiality of their information or Patients preferred E-mail communication for some interactions—for example, requesting prescription renewals and obtaining general medical information—while they preferred in-person communication for others—for example, getting treatment instructions. Telephone or written communication was never their preferred communication channel. In contrast, physicians preferred communicating by telephone rather than E-mail. More information is available in "Patient experiences and attitudes about access to a patient electronic health care record and linked Web messaging," by Andrea Hassol, et al in the November 2004 Journal of the American Medical Informatics Association 11(6), pp. 505-513. Conversations On Health With NIH Director Zerhouni The Kaiser Family Foundation will host NIH Director Elias Zerhouni for a "Kaiser Conversations on Health" live webcast on Tuesday, June 14, from noon to 1 p.m. Eastern Time. He will discuss national medical research and policy with Kaiser Family Foundation Vice President and former ABC News Correspondent Jackie Judd. The interview will touch on key issues such as new NIH conflict-of-interest and ethics rules, funding for medical research, the fight against HIV/AIDS, racial and ethnic disparities in health, ensuring public access to published NIH-supported research, and the state of NIH-funded stem cell research. Questions will be taken from the audience and via e-mail sent to conversations@kff.org. The live webcast will be available online. For more information, click: Racial/Ethnic Diversity in Health Services Research AcademyHealth, an organization based in Washington, DC, received a grant from the W.K. Kellogg Foundation to explore how to increase diversity in the field of health services research (HSR) by addressing these four goals: A copy of the report submitted to Kellogg may be obtained by clicking: House Appropriators Gut Health Professions Education Programs Today, the House Labor-HHS Appropriations Subcommittee approved the Labor, Health & Human Services, Education and Related Agencies draft bill for fiscal year 2006 by a voice vote that would eliminate all health professions education programs under Title VII of the Public Health Service Act except scholarships for disadvantaged students. That program would receive $47 million. The bill would provide NIH with $28.5 billion for medical research, a 0.5% increase, the smallest in 36 years. Health Informatics Grant Announced The National Library of Medicine will administer a $3.68 million grant from the Robert Wood Johnson Foundation to develop leaders in public health informatics, the National Institutes of Health announced today. The grant will support a training program to begin July 1 at Columbia University, the Johns Hopkins University School of Medicine, the University of Utah, and the University of Washington, including program development and trainee expenses. Survey Of Dental Hygienists Underway The Center for the Health Professions is conducting a statewide survey of registered dental hygienists in California. The project, slated for completion in July 2006, will examine practice patterns and professional issues facing dental hygiene, particularly in relation to improving access to dental care. Additional information may be obtained by clicking http://futurehealth.ucsf.edu/cchws/rdhsurvey.html . New Steps By HHS To Advance Health Information Technology HHS Secretary Mike Leavitt today announced the formation of a national collaboration and four requests for proposals (RFPs) that will advance efforts to reach President Bush's call for most Americans to have electronic health records within ten years. The President's vision would create a personal health record that patients, doctors, and other health care providers could securely access through the Internet no matter where a patient is seeking medical care. Today's announcement provides a way for patients, doctors, hospitals, insurance companies, and employers to agree on standards for electronic health records and ways to achieve interoperability -- the ability to access this vital medical information immediately and efficiently. The cornerstone of this effort, a private-public collaboration called the American Health Information Community (AHIC), will help nationwide transition to electronic health records -- including common standards and interoperability -- in a smooth, market-led way. HHS will solicit nominations for individuals to serve on the AHIC and Secretary Leavitt will appoint up to 17 commission members as well as serve as chairperson. HHS will also issue four RFPs to pave the way for interoperability. Estimating The Contributions Of Lifestyle-Related Factors To Preventable Death The Institute of Medicine of the National Academies held a workshop on December 13-14, 2004 to estimate the contributions of lifestyle-related factors to preventable death. The workshop's statement of task included these specific questions:
A sumary of the workshop can be obtained by clicking http://www.nap.edu/books/0309096901/html . The Condition Of Education 2005 A just released annual report on education in the United States provides a picture of both growth and diversity in education. According to The Condition of Education 2005 , issued by the U.S. Department of Education's National Center for Education Statistics (NCES) in the Institute of Education Sciences, enrollments in both public and private elementary and secondary schools have increased, with public school enrollments increasing at a faster rate. This congressionally mandated report conveys current information on 40 indicators that address the success of the education system in the United States. Indicators also are provided on the context of elementary and postsecondary education and the financial support for schooling at these levels. The report may be accessed by clicking http://nces.ed.gov/programs/coe/ . HHS And Health Information Technology The Department of Health and Human Services is taking steps to develop a national strategy regarding health information technology. A new report from the government Accountability Office (GAO) examines actions undertaken by the department to reduce medical errors, address rising health care costs, improve care quality, and produce greater value in the health industry. The report may be accessed by clicking http://www.gao.gov/new.items/d05628.pdf .
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