Rare diseases collectively affect millions of Americans of all ages, but developing drugs and medical devices to prevent, diagnose, and treat these conditions is challenging. The Institute of Medicine (IOM) recommends implementing an integrated national strategy to promote rare diseases research and product development.

The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.

Decisions large and small play a fundamental role in shaping life course trajectories of health and well-being: decisions draw upon an individual's capacity for self-regulation and self-control, their ability to keep long-term goals in mind, and their willingness to place appropriate value on their future well-being. Aging and Decision Making addresses the specific cognitive and affective processes that account for age-related changes in decision making, targeting interventions to compensate for vulnerabilities and leverage strengths in the aging individual. This book focuses on four dominant approaches that characterize the current state of decision-making science and aging - neuroscience, behavioral mechanisms, competence models, and applied perspectives. Underscoring that choice is a ubiquitous component of everyday functioning, Aging and Decision Making examines the implications of how we invest our limited social, temporal, psychological, financial, and physical resources, and lays essential groundwork for the design of decision supportive interventions for adaptive aging that take into account individual capacities and context variables. - Divided into four dominant approaches that characterize the current state of decision-making science and aging neuroscience - Explores the impact of aging on the linkages between cortical structures/functions and the behavioral indices of decision-making - Examines the themes associated with behavioral approaches that attempt integrations of methods, models, and theories of general decision-making with those derived from the study of aging - Details the changes in underlying competencies in later life and the two prevailing themes that have emerged—one, the general individual differences perspective, and two, a more clinical focus

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the Medicare Modernization Act, or MMA) substantially expanded the federal Medicare program by creating the prescription drug benefit known as Part D. In FY 2013, Medicare Part D covered 39 million people. The federal government spent $59 billion net of premiums on Part D in that year; after accounting for certain payments from states under the program, the net federal cost was $50 billion, which represented 10% of net federal spending for Medicare. A combination of broader trends in the prescription drug market and lower-than-expected enrollment in Part D has contributed to much lower spending for the program than projected when the MMA became law in 2003. This report examines the federal budgetary cost and competitive design of Medicare Part D and compares Medicare Part D and Medicaid Fee for Service. Figures and tables. This is a print on demand report.