About Publications

Publications from the National Academies of Sciences, Engineering, and Medicine provide objective and straightforward advice to decision makers and the public. This site includes Health and Medicine Division (HMD) publications released after 1998. A complete list of HMD’s publications from its establishment in 1970 to the present is available as a PDF.


  • Delivering High-Quality Cancer Care: Charting a New Course ... Released: September 10, 2013
    The IOM examined the quality of cancer care in the United States and concluded that the cancer care delivery system is in crisis due to a growing demand for cancer care, increasing complexity of treatment, a shrinking workforce, and rising costs. Changes across the board are urgently needed. All stakeholders – including cancer care teams, patients and their families, researchers, quality metrics developers, and payers, as well as HHS, other federal agencies, and industries – must reevaluate their current roles and responsibilities in cancer care and work together to develop a higher quality care delivery system. Working toward the recommendations outlined in this report, the cancer care community can improve the quality of life and outcomes for people facing a cancer diagnosis.
  • Variation in Health Care Spending: Target Decision Making ... Released: July 24, 2013
    For over three decades, researchers have documented large, systematic variation in Medicare fee-for-service spending and service use across geographic regions, seemingly unrelated to health outcomes. This variation has been interpreted by many to imply that high spending areas are overusing or misusing medical care. Policymakers, seeking strategies to reduce Medicare costs, naturally wonder if cutting payment rates to high cost areas would save money without adversely affecting Medicare beneficiary health care quality and outcomes. Yet, many have cautioned that geographically-based payment policies may have adverse effects if higher costs are caused by other variables like beneficiary burden of illness, or area policies that affect health outcomes.
  • Implementing a National Cancer Clinical Trials System for the ... Released: July 15, 2013
    Recognizing the recent transformative advances in cancer research that necessitate modernization in how cancer clinical trials are run, as well as inefficiencies and other challenges impeding the national cancer clinical trials program, the National Cancer Institute asked the IOM to develop a set of recommendations to improve the federally funded cancer clinical trials system. These recommendations were published in a 2010 IOM report. In 2011, the IOM’s National Cancer Policy Forum (NCPF) held a workshop to engage stakeholders in discussions about the changes they planned to implement in response to the IOM report. Two years later, the NCPF held a second workshop in which stakeholders reported the changes that they have made thus far to address the IOM recommendations, and discussed additional actions needed to improve the system.
  • Sharing Clinical Research Data - Workshop Summary : Health ... Released: March 29, 2013
    Pharmaceutical companies, academic researchers, and government agencies compile large quantities of clinical research data, which, if shared more widely both within and across sectors, could improve public health, enhance patient safety, and spur drug development. Despite several barriers to data sharing, there is increasing acknowledgement among researchers of the importance and potential benefits to sharing clinical research data at various stages of the research, discovery, and development pipeline. The IOM hosted a workshop to explore the benefits of sharing clinical research data, the barriers to such sharing, and strategies to address these barriers to facilitate the development of safe, effective therapeutics and diagnostics.
  • Geographic Variation in Health Care Spending and Promotion ... Released: March 22, 2013
    For over three decades, researchers have documented large, systematic variation in Medicare fee-for-service spending and service use across geographic regions, seemingly unrelated to health outcomes. This variation has been interpreted by many to imply that high spending areas are overusing or misusing medical care. Policymakers, seeking strategies to reduce Medicare costs, naturally wonder if cutting payment rates to high cost areas would save money without adversely affecting Medicare beneficiary health care quality and outcomes. Yet, many have cautioned that geographically-based payment policies may have adverse effects if higher costs are caused by other variables like beneficiary burden of illness, or area policies that affect health outcomes.
  • Delivering Affordable Cancer Care in the 21st Century ... Released: February 11, 2013
    Spending on health care currently accounts for 18 percent of the United States’ GDP. By 2037, that percentage is expected to increase to 25 percent of GDP. Spending on cancer care is expected to increase because of the rapid influx of new cancer diagnoses as the population ages. Also, as more expensive therapies and technologies become the standard of care, there are concerns that the costs of cancer treatment could begin to outpace health care inflation as a whole. The IOM held a workshop to examine the drivers of current and projected cancer care costs as well as potential ways to curb these costs while maintaining or improving the quality of care.
  • The Role of Telehealth in an Evolving Health Care ... Released: November 20, 2012
    Since the 1996 IOM report, Telemedicine: A Guide to Assessing Telecommunications for Health Care, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth. The IOM held a workshop to examine how the use of telehealth technology can fit into the U.S. health care system.
  • Reducing Tobacco-Related Cancer Incidence and Mortality ... Released: November 01, 2012
    Tobacco use is the leading cause of preventable death in the United States, causing more than 440,000 deaths every year. Tobacco use is linked to the development of 18 different types of cancer and accounts for at least 30 percent of all cancer deaths. Despite the widespread agreement on the dangers of tobacco use and considerable success in reducing the smoking rate by half since the first U.S. Surgeon General’s report on smoking in 1964, progress in reducing tobacco use has slowed in recent years. The IOM held a workshop to examine current challenges in tobacco control and to explore potential policy, outreach, and treatment strategies that could reduce tobacco-related cancer incidence and death.
  • Geographic Adjustment in Medicare Payment - Phase II ... Released: July 17, 2012
    Although Medicare is a national program, it adjusts payments to hospitals and health care practitioners according to the geographic location in which they provide service, acknowledging that the cost of doing business varies around the country. Under the adjustment systems, payments in high-cost areas are increased relative to the national average, and payments in low-cost areas are reduced. The HHS asked the IOM to conduct a two-part study to recommend corrections of inaccuracies and inequities in geographic adjustments to Medicare payments. In this report, the committee applies the first report’s recommendations in order to determine their potential effect on Medicare payments to hospitals and clinical practitioners.
  • Informatics Needs and Challenges in Cancer Research ... Released: July 16, 2012
    Informatics tools – which help collect, organize, and analyze data – are essential to biomedical and health research and development. The field of cancer research is facing an overwhelming deluge of data, heightening the national urgency to find solutions to support and sustain the cancer informatics ecosystem. The IOM’s National Cancer Policy Forum held a workshop February 27-28, 2012, to further examine informatics needs and challenges for 21st century biomedical research.