Consensus
Recent health care payment reforms aim to improve the alignment of Medicare payment strategies with goals to improve the quality of care provided, patient experiences with health care, and health outcomes, while also controlling costs. These efforts move Medicare away from the volume-based payment of traditional fee-for-service models and toward value-based purchasing, in which cost control is an explicit goal in addition to clinical and quality goals. Specific payment strategies include pay-for-performance and other quality incentive programs that tie financial rewards and sanctions to the quality and efficiency of care provided and accountable care organizations in which health care providers are held accountable for both the quality and cost of the care they deliver.
Accounting For Social Risk Factors in Medicare Payment is the fifth and final report in a series of brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report aims to put the entire series in context and offers additional thoughts about how to best consider the various methods for accounting for social risk factors, as well as next steps.
580 pages
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ISBN Paperback: 0-309-44920-0
ISBN Ebook: 0-309-44921-9
DOI:
https://doi.org/10.17226/23635
National Academies of Sciences, Engineering, and Medicine. 2017. Accounting for Social Risk Factors in Medicare Payment. Washington, DC: The National Academies Press.
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0 pages
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ISBN Ebook: 0309739616
DOI:
https://doi.org/10.17226/28108
National Research Council. 1968. Summary Report on Activities Within the Office of Scientific Personnel During Fiscal Year 1968. Washington, DC: The National Academies Press.
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Workshop_in_brief
The online information environment enables the global exchange of information and ideas, but it also contributes to the proliferation of disinformation. Online platforms operate at a scale where human-based content moderation to counter disinformation is impractical or at least very expensive and where purely technical solutions are challenging because content is often context-dependent. The speed, scale, and complexity of this ecosystem suggests that solutions are needed that consider the global nature of disinformation and effectively blend technical and human capabilities.
On April 10 and 11, 2024, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine's Committee on Science, Technology, and Law convened a virtual workshop to consider practicable solutions to counter online disinformation, particularly in social media. This publication summarizes the presentation and discussion of the workshop.
13 pages
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ISBN Ebook: 0-309-72790-1
DOI:
https://doi.org/10.17226/27997
National Academies of Sciences, Engineering, and Medicine. 2024. Evolving Technological, Legal, and Social Solutions to Counter Online Disinformation: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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Workshop
The National Academies Roundtable on Obesity Solutions hosted a public workshop in March 2024 to explore the current understanding of pharmacotherapy for overweight or obesity, the effects of medications intended for obesity and obesity-related comorbidities, and how complementary treatment options (such as nutrition and behavioral interventions) advance obesity care in conjunction with medication use. Speakers took care to highlight lived experiences, existing weight bias and stigma, and implications of pharmacotherapy on health policy, economics, access, clinical practice, and public health.
146 pages
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ISBN Paperback: 0-309-72578-X
ISBN Ebook: 0-309-72579-8
DOI:
https://doi.org/10.17226/27940
National Academies of Sciences, Engineering, and Medicine. 2024. Medications and Obesity: Exploring the Landscape and Advancing Comprehensive Care: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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Annual average daily traffic (AADT), which represents traffic on a typical day of the year, is used by transportation agencies for reporting requirements, allocating resources, informing decision-making, and supporting various agency functions.
NCHRP Research Report 1124: Guide on Methods for Assigning Counts to Adjustment Factor Groups, from TRB's National Cooperative Highway Research Program, provides information and guidance on the methods for assigning counts to adjustment factor groups used in estimating AADT.
Supplemental to the report is NCHRP Web-Only Document 406: Methods for Assigning Short-Duration Traffic Volume Counts to Adjustment Factor Groups to Estimate AADT.
104 pages
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ISBN Paperback: 0-309-72507-0
ISBN Ebook: 0-309-72508-9
DOI:
https://doi.org/10.17226/27925
National Academies of Sciences, Engineering, and Medicine. 2024. Guide on Methods for Assigning Counts to Adjustment Factor Groups. Washington, DC: The National Academies Press.
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Annual average daily traffic (AADT), which represents traffic on a typical day of the year, is used by transportation agencies for reporting requirements, allocating resources, informing decision-making, and supporting various agency functions.
NCHRP Web-Only Document 406: Methods for Assigning Short-Duration Traffic Volume Counts to Adjustment Factor Groups to Estimate AADT, from TRB's National Cooperative Highway Research Program, is a supplement to NCHRP Research Report 1124: Guide on Methods for Assigning Counts to Adjustment Factor Groups.
217 pages
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ISBN Ebook: 0-309-72511-9
DOI:
https://doi.org/10.17226/27926
National Academies of Sciences, Engineering, and Medicine. 2024. Methods for Assigning Short-Duration Traffic Volume Counts to Adjustment Factor Groups to Estimate AADT. Washington, DC: The National Academies Press.
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Workshop_in_brief
Behavioral threat assessment is a step-by-step process for evaluating individuals who threaten harm to others, making systematic judgments about the seriousness of the threat based on case-specific and dynamic risk factors, and identifying interventions necessary to support the individuals and reduce risk for harming others. On September 3 and 4, 2024, the National Academies of Sciences, Engineering, and Medicine held a workshop on K-12 Behavioral Threat Assessment Efficacy and Implementation Evaluation Research sponsored by the U.S. Secret Service's National Threat Assessment Center. The workshop was designed to explore existing literature on behavioral threat assessment, examine best practices and challenges to implementation, and identify future research needs. This publication summarizes the presentations and discussion of the workshop.
13 pages
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ISBN Ebook: 0-309-72711-1
DOI:
https://doi.org/10.17226/27980
National Academies of Sciences, Engineering, and Medicine. 2024. K-12 Behavioral Threat Assessment Efficacy and Implementation Evaluation Research: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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40 pages
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DOI:
https://doi.org/10.17226/28033
National Academies of Sciences, Engineering, and Medicine. 2024. Office of Diversity and Inclusion Annual Report 2023-2024: Building Momentum in Implementing Diversity, Equity, and Inclusion Initiatives. Washington, DC: The National Academies Press.
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The COVID-19 pandemic has been difficult for transit agencies seeking to serve the needs of the public while sustaining a safe environment for employees and passengers. Building and maintaining ridership are never easy, and the impacts of the pandemic were dramatic on ridership starting in March 2020.
NCHRP Web-Only Document 409: Sustaining Zero-Fare Public Transit in a Post COVID-19 World: Conduct of Research Report, from TRB's National Cooperative Highway Research Program, is designed to assist transit authorities that are considering continuing or moving to fare-free service.
The document is a supplement to NCHRP Research Report 1126: Sustaining Zero-Fare Public Transit in a Post COVID-19 World: A Guide for State DOTs.
116 pages
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ISBN Ebook: 0-309-72518-6
DOI:
https://doi.org/10.17226/27928
National Academies of Sciences, Engineering, and Medicine. 2024. Sustaining Zero-Fare Public Transit in a Post COVID-19 World: Conduct of Research Report. Washington, DC: The National Academies Press.
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Fare-free or zero-fare transit services have generated a great deal of interest in recent years. Fare-free operations unquestionably address many transportation equity issues. However, the long-term viability of these transit services must be carefully evaluated as these policy/programmatic decisions are made.
NCHRP Research Report 1126: Sustaining Zero-Fare Public Transit in a Post COVID- 19 World: A Guide for State DOTs, from TRB's National Cooperative Highway Research Program, develops guidance and a tool to aid practitioners in the evaluation of fare-free transit services from a state DOT perspective.
Supplemental to the report are NCHRP Web-Only Document 409: Sustaining Zero-Fare Public Transit in a Post COVID-19 World: Conduct of Research Report, an implementation plan, and a practitioner's tool.
76 pages
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paperback
ISBN Paperback: 0-309-72514-3
ISBN Ebook: 0-309-72515-1
DOI:
https://doi.org/10.17226/27927
National Academies of Sciences, Engineering, and Medicine. 2024. Sustaining Zero-Fare Public Transit in a Post COVID-19 World: A Guide for State DOTs. Washington, DC: The National Academies Press.
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Consensus
Women in the United States experience a higher prevalence of many chronic conditions, including Alzheimer's disease, depression, and osteoporosis, than men; they also experience female-specific conditions, such as endometriosis and pelvic floor disorders. A lack of research into both the biological and social factors that influence these conditions greatly hinders diagnosis, treatment, and prevention efforts, thus contributing to poorer health outcomes for women and substantial costs to individuals and for society.
The National Institutes of Health's Office of Research on Women's Health asked the National Academies of Sciences, Engineering, and Medicine to convene an expert committee to identify gaps in the science on chronic conditions that are specific to or predominantly impact women, or affect women differently, and propose a research agenda. The committee's report presents their conclusions and recommendations.
493 pages
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ISBN Paperback: 0-309-71864-3
ISBN Ebook: 0-309-71865-1
DOI:
https://doi.org/10.17226/27757
National Academies of Sciences, Engineering, and Medicine. 2024. Advancing Research on Chronic Conditions in Women. Washington, DC: The National Academies Press.
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Consensus
A high-quality preschool education can foster critical development and learning that promotes joyful, affirming, and enriching learning opportunities that prepare children for success in school and life. While preschool programs generally provide emotionally supportive environments, their curricula often fall short in advancing learning in math, early literacy, and science, and lack the necessary support for multilingual learners emerging bilingualism. Additionally, access to high-quality, effective early learning experiences may be limited and inadequate based on factors such as a childs race, location, gender, language, identified disability, and socioeconomic status.
A New Vision for High-Quality Preschool Curriculum examines preschool curriculum quality for children from ages three to five, with special attention to the needs of Black and Latine children, multilingual learners, children with disabilities and children experiencing poverty in the United States. The report articulates a vision for high-quality preschool curricula for all children, grounded in an equity and justice-oriented principles from inception to implementation and evaluation.
376 pages
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ISBN Paperback: 0-309-71401-X
ISBN Ebook: 0-309-71402-8
DOI:
https://doi.org/10.17226/27429
National Academies of Sciences, Engineering, and Medicine. 2024. A New Vision for High-Quality Preschool Curriculum. Washington, DC: The National Academies Press.
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The transition of asset information from the planning, design, and construction stages to the operations and maintenance (O&M) stage can be challenging. A successful asset information handover process will lead to informed O&M planning decisions, which may result in positive financial and functional impacts for O&M departments.
ACRP Research Report 264: Asset Information Handover Guidelines from Planning and Construction to Operations and Maintenance, from TRB's Airport Cooperative Research Program, presents guidelines for airport operators on establishing an asset information handover process during construction project closeout.
124 pages
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ISBN Paperback: 0-309-71001-4
ISBN Ebook: 0-309-72504-6
DOI:
https://doi.org/10.17226/27924
National Academies of Sciences, Engineering, and Medicine. 2024. Asset Information Handover Guidelines from Planning and Construction to Operations and Maintenance. Washington, DC: The National Academies Press.
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Consensus
Experiencing a single disaster - a hurricane, tornado, flood, severe winter storm, or a global pandemic - can wreak havoc on the lives and livelihoods of individuals, families, communities and entire regions. For many people who live in communities in the U.S. Gulf of Mexico region, the reality of disaster is starker. Endemic socioeconomic and health disparities have made many living in Gulf of Mexico communities particularly vulnerable to the effects of weather-climate hazards. Prolonged disaster recovery and increasing disaster risk is an enduring reality for many living in Gulf of Mexico communities. Between 2020 and 2021, seven major hurricanes and a severe winter storm affected communities across the region. As a backdrop to these acute weather events, the global COVID-19 pandemic was unfolding, producing a complex and unprecedented public health and socioeconomic crisis.
Traditionally, the impacts of disasters are quantified individually and often in economic terms of property damage and loss. In this case, each of these major events occurring in the Gulf of Mexico during this time period subsequently earned the moniker of "billion-dollar" disaster. However, this characterization does not reflect the non-financial human toll and disparate effects caused by multiple disruptive events that increase underlying physical and social vulnerabilities, reduce adaptive capacities and ultimately make communities more sensitive to the effects of future disruptive events. This report explores the interconnections, impacts, and lessons learned of compounding disasters that impair resilience, response, and recovery efforts. While Compounding Disasters in Gulf Coast Communities, 2020-2021 focuses on the Gulf of Mexico region, its findings apply to any region that has similar vulnerabilities and that is frequently at risk for disasters.
296 pages
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ISBN Paperback: 0-309-70716-1
ISBN Ebook: 0-309-70717-X
DOI:
https://doi.org/10.17226/27170
National Academies of Sciences, Engineering, and Medicine. 2024. Compounding Disasters in Gulf Coast Communities 2020-2021: Impacts, Findings, and Lessons Learned. Washington, DC: The National Academies Press.
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Rapid_expert_consultation
Factors related to the COVID-19 pandemic contributed to profound disruptions in childhood vaccination schedules and access. While childhood immunization rates have rebounded to nearly pre-pandemic levels, disparities in coverage by race, ethnicity, poverty status, insurance status, and urbanicity persist and, in some cases, have been exacerbated. Addressing these gaps and disparities necessitates multifaceted and targeted interventions, employing robust efforts at the policy, health systems, and provider levels to sustain and increase vaccination rates across diverse populations, along with individual- and community-level strategies aimed at improving vaccine attitudes. A key component of these strategies is building trust with both parent and provider communities at multiple levels, including healthcare, public health, and government agencies involved with approving and recommending vaccines.
Within this framework, this rapid expert consultation identifies strategies for promoting childhood immunization with a particular focus on populations with lower vaccination rates, including Black, Hispanic, and American Indian/Alaska Native children; those living in rural areas; people with lower incomes; and people who lack health insurance. This consultation focuses on targeted strategies for supporting resilient immunization services, addressing access barriers, promoting vaccine confidence and uptake, and providing accurate information while countering misinformation and disinformation.
25 pages
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ISBN Ebook: 0-309-72699-9
DOI:
https://doi.org/10.17226/27977
National Academies of Sciences, Engineering, and Medicine. 2024. Guidance on Routine Childhood Immunizations. Washington, DC: The National Academies Press.
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Consensus
For more than 75 years, high-hazard structures in the U.S., including dams and nuclear power plants, have been engineered to withstand floods resulting from the most unlikely but possible precipitation, termed Probable Maximum Precipitation (PMP). Failure of any one of the more than 16,000 high-hazard dams and 50 nuclear power plants in the United States could result in the loss of life and impose significant economic losses and widespread environmental damage, especially under the pressures of climate change. While PMP estimates have provided useful guidance for designing critical infrastructure, weaknesses in the scientific foundations of PMP, combined with advances in understanding, observing, and modeling extreme storms, call for fundamental changes to the definition of PMP and the methods used to estimate it.
Modernizing Probable Maximum Precipitation Estimation recommends a new definition of PMP and presents a vision for a methodology relevant for design, operation, and regulation of critical infrastructure. The new definition targets precipitation depths with an extremely low exceedance probability instead of assuming rainfall is bounded, and considers specified climate periods so that PMP estimates can change as the climate changes. Near-term enhancements to PMP include improved data collection, model-based storm reconstructions, and strengthened scientific grounding for PMP methods. Long-term model-based PMP estimation will employ kilometer-scale climate models capable of resolving PMP storms and producing PMP-magnitude precipitation. A Model Evaluation Project will provide scientific grounding for model-based PMP estimation and determine when transition to a model-based PMP estimation should occur. Scientific and modeling advances along this front will contribute to addressing the societal challenges linked to the changes in extreme storms and precipitation in a warming climate, which are critical steps to ensuring the safety of our infrastructure and society.
212 pages
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ISBN Paperback: 0-309-71511-3
ISBN Ebook: 0-309-72287-X
DOI:
https://doi.org/10.17226/27460
National Academies of Sciences, Engineering, and Medicine. 2024. Modernizing Probable Maximum Precipitation Estimation. Washington, DC: The National Academies Press.
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Workshop
People with disabilities can be any age, face chronic health conditions or mental illness, be racial or ethnic minorities, experience low income or housing insecurity, have limited English proficiency, or a combination of many of these conditions. To better understand the effect of health inequities and the manner in which they affect Social Security Administration's (SSA) disability programs, the National Academies hosted a public workshop in April 2024 that examined the variety of different experiences of individuals with disabilities and the consequences of those experiences on an individual's health status, medical record, and SSA disability determinations.
144 pages
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ISBN Paperback: 0-309-72444-9
ISBN Ebook: 0-309-72445-7
DOI:
https://doi.org/10.17226/27909
National Academies of Sciences, Engineering, and Medicine. 2024. Health Disparities in the Medical Record and Disability Determinations: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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Historically, ridership has been the primary way transit agencies have communicated their success and public value in making connections for community. Several transit agencies have shifted services and enhanced performance tracking in recent years in ways that relate to the inequities tied to race, ethnicity, national origin, physical ability, income, age, or gender.
TCRP Synthesis 176: Transit Agency Goals and Non-Traditional Performance Indicators Focused on Equity, from TRB's Transit Cooperative Research Program, documents the current practice of transit systems using non-traditional indicators to measure and improve equity as it relates to service planning and the customer experience.
150 pages
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paperback
ISBN Paperback: 0-309-72493-7
ISBN Ebook: 0-309-72494-5
DOI:
https://doi.org/10.17226/27922
National Academies of Sciences, Engineering, and Medicine. 2024. Transit Agency Goals and Non-Traditional Performance Indicators Focused on Equity. Washington, DC: The National Academies Press.
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Consensus
The United States is an important food producer globally, in part because of its abundance of agriculturally productive soils. However, management practices that maximize yields have caused losses in soil organic matter, poor soil structure and water-holding capacity, and increased salinity on millions of acres of land - and have adversely affected the microbial communities that are the drivers of many soil processes. At the same time, recent scientific advances have spurred interest in how microbial communities can support soil health, food quality, and human health.
It is in this context that the U.S. Department of Agriculture National Institute of Food and Agriculture asked the National Academies to explore the linkages between soil health and human health. The report finds that to improve soil health, federal agencies need to promote the importance of soil health, support translational research, and develop a coordinated national approach to monitor soil health over time and space. Given the potential that microbiomes have in modulating soil, plant, and human health, there is also a pressing need to determine which microbial features, if any, contribute to quantifying or fortifying health in both human and soil systems and to understand the direct and indirect roles of soil, alongside other environmental factors, in influencing human microbial colonization and subsequent health outcomes. Such investigation involves delving into the relatively sparse or disconnected research regarding the microbiome continuum that links soil and human systems.
354 pages
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ISBN Paperback: 0-309-71508-3
ISBN Ebook: 0-309-72265-9
DOI:
https://doi.org/10.17226/27459
National Academies of Sciences, Engineering, and Medicine. 2024. Exploring Linkages Between Soil Health and Human Health. Washington, DC: The National Academies Press.
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