high priority as health reform moves forward, and they must be diverse enough to reach groups with particular social, economic, and health needs. These are significant challenges and responsibilities for public agencies and private health plans that engage in reform efforts at the state and local levels, as well as for the federal government.


The challenges and questions raised in this White Paper call for considerable investments of time, money, and effort from many different constituencies. To respond to this need the IOM is pursuing its existing quality-of-care agenda and applying it aggressively to the points raised in this White Paper through a special initiative, designated “America's Health in Transition: Protecting and Improving the Quality of Health and Health Care." This IOM-wide, 3-year effort will be coordinated, focused examination of quality-of-care issues. The IOM has more than 20 years of experience in drawing attention to problems of inadequate systems of care and deficiencies in health services, as well as in devising approaches to measuring and assuring quality (see the Bibliography). This past work will be a solid starting point. In addition, the IOM will undertake further activities as the direction of health reform evolves, with special attention to the health of the public and to that of specific vulnerable populations. This program will involve both analytic studies and convening activities such as forums and workshops. Through this initiative, the IOM will remind policymakers and the public of the need for continuing efforts to monitor and improve the health and well-being of Americans and the quality of care that they receive during this period of potentially rapid and unpredictable change.

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