BIO2010

by National Research Council, Division on Earth and Life Studies, Board on Life Sciences, Committee on Undergraduate Biology Education to Prepare Research Scientists for the 21st Century

2003 · National Academies Press

Biological sciences have been revolutionized, not only in the way research is conductedâ€"with the introduction of techniques such as recombinant DNA and digital technologyâ€"but also in how research findings are communicated among professionals and to the public. Yet, the undergraduate programs that train biology researchers remain much the same as they were before these fundamental changes came on the scene. This new volume provides a blueprint for bringing undergraduate biology education up to the speed of today's research fast track. It includes recommendations for teaching the next generation of life science investigators, through: Building a strong interdisciplinary curriculum that includes physical science, information technology, and mathematics. Eliminating the administrative and financial barriers to cross-departmental collaboration. Evaluating the impact of medical college admissions testing on undergraduate biology education. Creating early opportunities for independent research. Designing meaningful laboratory experiences into the curriculum. The committee presents a dozen brief case studies of exemplary programs at leading institutions and lists many resources for biology educators. This volume will be important to biology faculty, administrators, practitioners, professional societies, research and education funders, and the biotechnology industry.

Accounting for Social Risk Factors in Medicare Payment

by National Academies of Sciences, Engineering, and Medicine, Institute of Medicine, Board on Health Care Services, Board on Population Health and Public Health Practice, Committee on Accounting for Socioeconomic Status in Medicare Payment Programs

2016 · National Academies Press

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: Identifying Social Risk Factors is the first in a series of five reports commissioned to provide input into whether socioeconomic status (SES) and other social risk factors could be accounted for in Medicare payment and quality programs. This report focuses on defining SES and other social factors for the purposes of application to Medicare quality measurement and payment programs.

Systems Practices for the Care of Socially At-Risk Populations

by National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Care Services, Board on Population Health and Public Health Practice, Committee on Accounting for Socioeconomic Status in Medicare Payment Programs

2016 · National Academies Press

The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.

Genes, Behavior, and the Social Environment

by Institute of Medicine, Board on Health Sciences Policy, Committee on Assessing Interactions Among Social, Behavioral, and Genetic Factors in Health

2006 · National Academies Press

Over the past century, we have made great strides in reducing rates of disease and enhancing people's general health. Public health measures such as sanitation, improved hygiene, and vaccines; reduced hazards in the workplace; new drugs and clinical procedures; and, more recently, a growing understanding of the human genome have each played a role in extending the duration and raising the quality of human life. But research conducted over the past few decades shows us that this progress, much of which was based on investigating one causative factor at a time—often, through a single discipline or by a narrow range of practitioners—can only go so far. Genes, Behavior, and the Social Environment examines a number of well-described gene-environment interactions, reviews the state of the science in researching such interactions, and recommends priorities not only for research itself but also for its workforce, resource, and infrastructural needs.