TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Ruby Takanishi A2 - Suzanne Le Menestrel TI - Promoting the Educational Success of Children and Youth Learning English: Promising Futures SN - DO - 10.17226/24677 PY - 2017 UR - https://nap.nationalacademies.org/catalog/24677/promoting-the-educational-success-of-children-and-youth-learning-english PB - The National Academies Press CY - Washington, DC LA - English KW - Education KW - Behavioral and Social Sciences AB - Educating dual language learners (DLLs) and English learners (ELs) effectively is a national challenge with consequences both for individuals and for American society. Despite their linguistic, cognitive, and social potential, many ELs—who account for more than 9 percent of enrollment in grades K-12 in U.S. schools—are struggling to meet the requirements for academic success, and their prospects for success in postsecondary education and in the workforce are jeopardized as a result. Promoting the Educational Success of Children and Youth Learning English: Promising Futures examines how evidence based on research relevant to the development of DLLs/ELs from birth to age 21 can inform education and health policies and related practices that can result in better educational outcomes. This report makes recommendations for policy, practice, and research and data collection focused on addressing the challenges in caring for and educating DLLs/ELs from birth to grade 12. ER - TY - BOOK AU - Institute of Medicine A2 - Cheryl Ulmer A2 - Bernadette McFadden A2 - David R. Nerenz TI - Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement SN - DO - 10.17226/12696 PY - 2009 UR - https://nap.nationalacademies.org/catalog/12696/race-ethnicity-and-language-data-standardization-for-health-care-quality PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Lyla M. Hernandez TI - Health Communication with Immigrants, Refugees, and Migrant Workers: Proceedings of a Workshop—in Brief DO - 10.17226/24796 PY - 2017 UR - https://nap.nationalacademies.org/catalog/24796/health-communication-with-immigrants-refugees-and-migrant-workers-proceedings-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - In March 2017, the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine convened a workshop focused on health communication with people from immigrant, refugee, and migrant worker populations. The workshop was organized to explore the application of health literacy insights to the issues and challenges associated with addressing the health of immigrants, refugees, and migrant workers. Participants explored issues of access and services for these populations as well as outreach and action. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research SN - DO - 10.17226/24625 PY - 2017 UR - https://nap.nationalacademies.org/catalog/24625/the-health-effects-of-cannabis-and-cannabinoids-the-current-state PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agenda—outlining gaps in current knowledge and opportunities for providing additional insight into these issues—that summarizes and prioritizes pressing research needs. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Steven M. Teutsch A2 - Amy B. Geller A2 - Aimee M. Mead TI - Premium Cigars: Patterns of Use, Marketing, and Health Effects SN - DO - 10.17226/26421 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26421/premium-cigars-patterns-of-use-marketing-and-health-effects PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The early to mid-1990s saw a large surge in U.S. cigar consumption, including premium cigars. Based on recent import data, premium cigar use may be increasing, though they currently make up a small percent of the total U.S. cigar market. Premium cigars have also been the subject of legal and regulatory efforts for the past decade. In 1998, the National Cancer Institute undertook a comprehensive review of available knowledge about cigars - the only one to date. The resulting research recommendations have largely not been addressed, and many of the identified information gaps persist. Furthermore, there is no single, consistent definition of premium cigars, making research challenging. In response, the Food and Drug Administration (FDA) and the National Institutes of Health commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee of experts to address this issue. The resulting report, Premium Cigars: Patterns of Use, Marketing, and Health Effects, includes 13 findings, 24 conclusions, and nine priority research recommendations and assesses the state of evidence on premium cigar characteristics, current patterns of use, marketing and perceptions of the product, and short- long-term health effects. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Barbara O. Schneeman A2 - Ann L. Yaktine A2 - Alice Vorosmarti TI - Scanning for New Evidence on Riboflavin to Support a Dietary Reference Intake Review SN - DO - 10.17226/26188 PY - 2021 UR - https://nap.nationalacademies.org/catalog/26188/scanning-for-new-evidence-on-riboflavin-to-support-a-dietary-reference-intake-review PB - The National Academies Press CY - Washington, DC LA - English KW - Food and Nutrition AB - The Dietary Reference Intakes (DRIs) are a set of evidence-based nutrient reference values for intakes that include the full range of age, gender, and life stage groups in the US and Canada. At the request of the U.S. Department of Agriculture, Agricultural Research Service and the U.S. Department of Health and Human Services, Food and Drug Administration, Center for Food Safety and Applied Nutrition, the National Academies of Science, Engineering, and Medicine convened an ad hoc committee to carry out a literature search and evidence scan of the peer-reviewed published literature on indicators of nutritional requirements, toxicity, and chronic disease risk reduction for riboflavin. Scanning for New Evidence on Riboflavin to Support a Dietary Reference Intake Review builds on the methodology for evidence scanning nutrients (which have existing DRIs) to determine whether there is new and relevant knowledge available that may merit a formal reexamination of DRIs for riboflavin. This report offers comments on the methodological approach to the evidence scan and discusses its findings and interpretation of the process to provide the study sponsors with a greater context to support their interpretation and application of the reported results. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Joe Alper TI - Facilitating Health Communication with Immigrant, Refugee, and Migrant Populations Through the Use of Health Literacy and Community Engagement Strategies: Proceedings of a Workshop SN - DO - 10.17226/24845 PY - 2017 UR - https://nap.nationalacademies.org/catalog/24845/facilitating-health-communication-with-immigrant-refugee-and-migrant-populations-through-the-use-of-health-literacy-and-community-engagement-strategies PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The increasingly diverse ethnic composition of the United States population has created a profound and ongoing demographic shift, and public health and health care organizations face many challenges as they move to address and adapt to this change. To better understand how the public health and health care communities can meet the challenges of serving an increasingly diverse population, the Roundtable on Health Literacy conducted a public workshop on facilitating health communication with immigrant, refugee, and migrant populations through the use of health literate approaches. The goal of the workshop was to identify approaches that will enable organizations that serve these ethnically and culturally diverse populations in a manner that allows all members of these communities to obtain, process, and understand basic health information and the services needed to make appropriate health and personal decisions. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Carla Alvarado A2 - Lauren Savaglio TI - A Population Health Perspective on Middle School Success: Activities, Programs, and Policies: Proceedings of a Workshop SN - DO - 10.17226/25807 PY - 2021 UR - https://nap.nationalacademies.org/catalog/25807/a-population-health-perspective-on-middle-school-success-activities-programs PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - On December 5, 2019, the Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine convened a workshop to explore the factors that affect the health and well-being of middle-school-aged adolescents. The workshop included presentations on the risk factors of poor physical, social, and emotional outcomes and their prevalence; the identification of resilience factors; current policies and programs designed to support middle school success and address issues of equity and financing as they apply to these; and how the health and human services sectors can support and align with the education sector to promote health and well-being in middle school. This publication summarizes the presentations and discussions that took place during the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Dietary Reference Intakes for Energy SN - DO - 10.17226/26818 PY - 2023 UR - https://nap.nationalacademies.org/catalog/26818/dietary-reference-intakes-for-energy PB - The National Academies Press CY - Washington, DC LA - English KW - Food and Nutrition KW - AB - The Dietary Reference Intakes (DRIs) are a set of reference values that encompass a safe range of intake and provide recommended nutrient intakes for the United States and Canada. The DRIs for energy are used widely to provide guidance for maintaining energy balance on both an individual and group level. U.S. and Canadian governments asked the National Academies to convene an expert committee to examine available evidence and provide updated Estimated Energy Requirements (EERs) for their populations. The resulting report presents EER equations that provide a baseline for dietary planners and assessors who are estimating energy needs and monitoring energy balance to enhance the general health of individuals and populations. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Considerations for the Design of a Systematic Review of Care Interventions for Individuals with Dementia and Their Caregivers: Letter Report SN - DO - 10.17226/25326 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25326/considerations-for-the-design-of-a-systematic-review-of-care-interventions-for-individuals-with-dementia-and-their-caregivers PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Considerations for the Design of a Systematic Review of Care Interventions for Individuals with Dementia and Their Caregivers: Letter Report provides input into the design of an Agency for Healthcare Research and Quality (AHRQ) systematic review of evidence on effective care-related interventions for people with dementia and their caregivers. This letter report describes potential changes and considerations for the key questions and study design that would result in the most informative and timely evidence review on this topic. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Kat M. Anderson TI - COVID-19, Health Equity, and the Asian American, Native Hawaiian, and Pacific Islander Communities: Proceedings of a Workshop—in Brief DO - 10.17226/26700 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26700/covid-19-health-equity-and-the-asian-american-native-hawaiian-and-pacific-islander-communities PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Communities of color have been among the hardest hit by the COVID virus. Less is known, however, about infection and vaccination rates in the different populations that make up the Asian American, Native Hawaiian, and Pacific Islander (AA/NH/PI) communities. In at least 16 states that do disaggregate their data, Native Hawaiians and Pacific Islanders have the highest mortality rates. Additionally, reports of incidents of xenophobia and violence against AANHPI community members, particularly women, became more frequent during the pandemic. Finally, there is a lack of data on AANHPI health and well-being in comparison to other groups, which will make it more difficult to correct these disparities in the future. The National Academies of Sciences, Engineering, and Medicine's Roundtable on the Promotion of Health Equity planned and hosted a 2-day public workshop in December 2021 titled COVID-19, Health Equity, and the Asian American, Pacific Islander, and Native Hawaiian Communities. The workshop focused on the impact of the COVID-19 pandemic and the unique obstacles faced by the AANHPI communities in achieving health equity. This Proceedings of a Workshop-In Brief summarizes the events covered in the workshop discussions. ER - TY - BOOK AU - Institute of Medicine TI - Defining Primary Care: An Interim Report DO - 10.17226/9153 PY - 1994 UR - https://nap.nationalacademies.org/catalog/9153/defining-primary-care-an-interim-report PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine ER - TY - BOOK AU - Institute of Medicine A2 - Lynn Nielsen-Bohlman A2 - Allison M. Panzer A2 - David A. Kindig TI - Health Literacy: A Prescription to End Confusion SN - DO - 10.17226/10883 PY - 2004 UR - https://nap.nationalacademies.org/catalog/10883/health-literacy-a-prescription-to-end-confusion PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - To maintain their own health and the health of their families and communities, consumers rely heavily on the health information that is available to them. This information is at the core of the partnerships that patients and their families forge with today’s complex modern health systems. This information may be provided in a variety of forms – ranging from a discussion between a patient and a health care provider to a health promotion advertisement, a consent form, or one of many other forms of health communication common in our society. Yet millions of Americans cannot understand or act upon this information. To address this problem, the field of health literacy brings together research and practice from diverse fields including education, health services, and social and cultural sciences, and the many organizations whose actions can improve or impede health literacy. Health Literacy: Prescription to End Confusion examines the body of knowledge that applies to the field of health literacy, and recommends actions to promote a health literate society. By examining the extent of limited health literacy and the ways to improve it, we can improve the health of individuals and populations. ER - TY - BOOK AU - Institute of Medicine A2 - Maria Hewitt TI - Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary SN - DO - 10.17226/13255 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13255/facilitating-state-health-exchange-communication-through-the-use-of-health-literate-practices PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Implementation of the Affordable Care Act (ACA) of 2010 will result in significant changes to the U.S. health care system. Among its many provisions, the ACA will extend access to health care coverage to millions of Americans who have been previously uninsured. Many of the newly eligible health insurance consumers will be individuals of low health literacy, some speakers of English and others more comfortable using languages other than English. Health insurance terms such as "deductible," "co-insurance," and "out-of-pocket limit" are difficult to communicate even to those with moderate-to-high levels of health literacy and so health exchanges will face challenges as they attempt to communicate to the broader community. In addition to having to convey some of these basic, and yet complex, principles of insurance, state exchanges will be attempting to adapt to the many changes to enrollment and eligibility brought about by ACA. The Institute of Medicine (IOM) convened the Roundtable on Health Literacy that brings together leaders from the federal government, foundations, health plans, associations, and private companies to discuss challenges facing health literacy practice and research and to identify approaches to promote health literacy in both the public and private sectors. The roundtable sponsored a workshop in Washington, DC, on July 19, 2011, that focused on ways in which health literacy can facilitate state health insurance exchange communication with potential enrollees. The roundtable's workshop focused on four topics: (1) lessons learned from existing state insurance exchanges; (2) the impact of state insurance exchanges on consumers; (3) the relevance of health literacy to health insurance exchanges; and (4) current best practices in developing materials and communicating with consumers. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices summarizes the presentations and discussion that occurred during the workshop. The report provides an overview of health insurance exchanges, presents evidence on the extent to which consumers understand underlying health insurance concepts, and describes the relevancy of health literacy to health insurance reform and how health literacy interventions can facilitate the implementation of health insurance reforms. The report also provides a review of best practices in developing materials and communicating with consumers, and concludes with reflections on the workshop presentations and discussions by members of the roundtable and its chair. Further information is provided in the appendixes, the workshop agenda (Appendix A), workshop speaker biosketches (Appendix B), and testimony provided by the organization America's Health Insurance Plans (AHIP) (Appendix C). ER - TY - BOOK AU - Institute of Medicine A2 - Jill Eden A2 - Ben Wheatley A2 - Barbara McNeil A2 - Harold Sox TI - Knowing What Works in Health Care: A Roadmap for the Nation SN - DO - 10.17226/12038 PY - 2008 UR - https://nap.nationalacademies.org/catalog/12038/knowing-what-works-in-health-care-a-roadmap-for-the PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - There is currently heightened interest in optimizing health care through the generation of new knowledge on the effectiveness of health care services. The United States must substantially strengthen its capacity for assessing evidence on what is known and not known about "what works" in health care. Even the most sophisticated clinicians and consumers struggle to learn which care is appropriate and under what circumstances. Knowing What Works in Health Care looks at the three fundamental health care issues in the United States—setting priorities for evidence assessment, assessing evidence (systematic review), and developing evidence-based clinical practice guidelines—and how each of these contributes to the end goal of effective, practical health care systems. This book provides an overall vision and roadmap for improving how the nation uses scientific evidence to identify the most effective clinical services. Knowing What Works in Health Care gives private and public sector firms, consumers, health care professionals, benefit administrators, and others the authoritative, independent information required for making essential informed health care decisions. ER - TY - BOOK AU - Institute of Medicine A2 - Kathleen M. Rasmussen A2 - Marie E. Latulippe A2 - Ann L. Yaktine TI - Review of WIC Food Packages: An Evaluation of White Potatoes in the Cash Value Voucher: Letter Report SN - DO - 10.17226/20221 PY - 2015 UR - https://nap.nationalacademies.org/catalog/20221/review-of-wic-food-packages-an-evaluation-of-white-potatoes PB - The National Academies Press CY - Washington, DC LA - English KW - Food and Nutrition AB - Review of WIC Food Packages: An Evaluation of White Potatoes in the Cash Value Voucher assesses the impact of 2009 regulation to allow the purchase of vegetables and fruits, excluding white potatoes, with a cash value voucher on food and nutrient intakes of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) population and to consider whether white potatoes should be permitted for purchase with the voucher. This report considers the effects on diet quality, the health and cultural needs of the WIC population, and allows for effective and efficient administration nationwide in a cost-effective manner. Review of WIC Food Packages: An Evaluation of White Potatoes in the Cash Value Voucher recommends that the U.S. Department of Agriculture should allow white potatoes as a WIC-eligible vegetable, in forms currently permitted for other vegetables, in the cash value voucher pending changes to starchy vegetable intake recommendations in the 2015 Dietary Guidelines for Americans. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Accounting for Social Risk Factors in Medicare Payment: Data SN - DO - 10.17226/23605 PY - 2016 UR - https://nap.nationalacademies.org/catalog/23605/accounting-for-social-risk-factors-in-medicare-payment-data PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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: Data is the fourth in a series of five 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 provides guidance on data sources for and strategies to collect data on indicators of social risk factors that could be accounted for Medicare quality measurement and payment programs. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Kelly McHugh A2 - Rose Marie Martinez A2 - Joe Alper TI - Adoption of Health Literacy Best Practices to Enhance Clinical Research and Community Participation: Proceedings of a Workshop—in Brief DO - 10.17226/26506 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26506/adoption-of-health-literacy-best-practices-to-enhance-clinical-research-and-community-participation PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Clinical research is critical to developing new treatments and therapies for patients. To maximize societal benefit and health equity, it is important that clinical research information be accessible and inclusive, and participants should be representative of the patient population. To explore the role that patient comprehension of clinical research can have in delivering high-quality clinical care and in increasing the diversity of the populations enrolled in clinical research, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Health Literacy held a virtual public workshop on October 28, 2021. Workshop attendees discussed current and promising resources and approaches for ensuring that the public receives clinical research information in accessible language that promotes health literacy. They also discussed strategies for integrating clinical research information into various care and community settings to improve research awareness and engagement. This Proceedings of a Workshop-in Brief highlights the presentations and discussions of the workshop. ER - TY - BOOK AU - Institute of Medicine A2 - Lyla M. Hernandez TI - Measures of Health Literacy: Workshop Summary SN - DO - 10.17226/12690 PY - 2009 UR - https://nap.nationalacademies.org/catalog/12690/measures-of-health-literacy-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Health literacy--the ability for individuals to obtain, process, and understand basic health information and services to facilitate appropriate health decisions--is increasingly recognized as an important facet of health care and health outcomes. Although research on health literacy has grown tremendously in the past decade, there is no widely agreed-upon framework for health literacy as a determinant of health outcomes. Most instruments focus on assessing an individual's health literacy, yet the scope of health literacy reaches far beyond an individual's skills and abilities. Health literacy occurs in the context of the health care system, and therefore measures of health literacy must also assess the demands and complexities of the health care systems with which patients interact. For example, measures are needed to determine how well the system has been organized so that it can be navigated by individuals with different levels of health literacy and how well health organizations are doing at making health information understandable and actionable. To examine what is known about measures of health literacy, the Institute of Medicine convened a workshop. The workshop, summarized in this volume, reviews the current status of measures of health literacy, including those used in the health care setting; discusses possible surrogate measures that might be used to assess health literacy; and explores ways in which health literacy measures can be used to assess patient-centered approaches to care. ER - TY - BOOK AU - Institute of Medicine A2 - Valerie Tate Jopeck A2 - Marion Ein Lewin TI - Developing an Information Infrastructure for the Medicare+Choice Program: Summary of a Workshop SN - DO - 10.17226/6419 PY - 1999 UR - https://nap.nationalacademies.org/catalog/6419/developing-an-information-infrastructure-for-the-medicarechoice-program-summary-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - On March 4 and 5, 1998, the Institute of Medicine (IOM) Committee on Choice and Managed Care held a 2-day workshop entitled Developing the Information Infrastructure for Medicare Beneficiaries. This workshop was a follow-up to the IOM report entitled Improving the Medicare Market: Adding Choice and Protections. The workshop focused on the Medicare provisions in the Balanced Budget Act of 1997, which mandate that the Health Care Financing Administration (HCFA) develop a "nationally coordinated education and publicity campaign" in 1998 and move Medicare beneficiaries to an open-season enrollment process by the year 2002. ER -