Health Affairs

Article	Citations
Strong Social Distancing Measures In The United States Reduced The COVID-19 Growth Rate	591
Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US	541
Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California	462
The Impact Of The COVID-19 Pandemic On Hospital Admissions In The United States	362
COVID-19 And Racial/Ethnic Disparities In Health Risk, Employment, And Household Composition	318
Health Care Pollution And Public Health Damage In The United States: An Update	282
Variation In Telemedicine Use And Outpatient Care During The COVID-19 Pandemic In The United States	280
Systemic And Structural Racism: Definitions, Examples, Health Damages, And Approaches To Dismantling	268
The Potential Health Care Costs And Resource Use Associated With COVID-19 In The United States	264
Physicians’ Perceptions Of People With Disability And Their Health Care	213
Self-Isolation Compliance In The COVID-19 Era Influenced By Compensation: Findings From A Recent Survey In Israel	185
Severe Staffing And Personal Protective Equipment Shortages Faced By Nursing Homes During The COVID-19 Pandemic	180
Community-Level Factors Associated With Racial And Ethnic Disparities In COVID-19 Rates In Massachusetts	163
Improving The Measurement Of Structural Racism To Achieve Antiracist Health Policy	153
Structural Racism In Historical And Modern US Health Care Policy	148
Negative Patient Descriptors: Documenting Racial Bias In The Electronic Health Record	141
Racial And Ethnic Inequities In Children’s Neighborhoods: Evidence From The New Child Opportunity Index 2.0	139
Clinical Outcomes Of A COVID-19 Vaccine: Implementation Over Efficacy	138
Incarceration And Its Disseminations: COVID-19 Pandemic Lessons From Chicago’s Cook County Jail	134
Disparities In Telehealth Use Among California Patients With Limited English Proficiency	128
High Nursing Staff Turnover In Nursing Homes Offers Important Quality Information	123
National Health Care Spending In 2019: Steady Growth For The Fourth Consecutive Year	114
Actualizing Better Health And Health Care For Older Adults	112
Transforming The Medical Device Industry: Road Map To A Circular Economy	105
Racial/Ethnic Disparities In COVID-19 Exposure Risk, Testing, And Cases At The Subcounty Level In California	102

Staying Connected In The COVID-19 Pandemic: Telehealth At The Largest Safety-Net System In The United States	102
Estimating The Infection Fatality Rate Among Symptomatic COVID-19 Cases In The United States	88
Vaccinations Against COVID-19 May Have Averted Up To 140,000 Deaths In The United States	83
Impact Of The Healthy, Hunger-Free Kids Act On Obesity Trends	82
Health Risks Due To Climate Change: Inequity In Causes And Consequences	76
Preventing Pregnancy-Related Mental Health Deaths: Insights From 14 US Maternal Mortality Review Committees, 2008–17	75
COVID-19 Vaccine To Vaccination: Why Leaders Must Invest In Delivery Strategies Now	74
Critical Care And Emergency Department Response At The Epicenter Of The COVID-19 Pandemic	73
Shelter-In-Place Orders Reduced COVID-19 Mortality And Reduced The Rate Of Growth In Hospitalizations	70
Spreading Fear: The Announcement Of The Public Charge Rule Reduced Enrollment In Child Safety-Net Programs	68
COVID-19 Emergency Sick Leave Has Helped Flatten The Curve In The United States	65
Primary Care Practice Finances In The United States Amid The COVID-19 Pandemic	62
National Health Care Spending In 2020: Growth Driven By Federal Spending In Response To The COVID-19 Pandemic	61
Addressing Racial And Ethnic Disparities In The Use Of Medications For Opioid Use Disorder	61
Consolidation Of Providers Into Health Systems Increased Substantially, 2016–18	61
‘I Am Not The Doctor For You’: Physicians’ Attitudes About Caring For People With Disabilities	60
Fewer Pharmacies In Black And Hispanic/Latino Neighborhoods Compared With White Or Diverse Neighborhoods, 2007–15	59
Neighborhood Racial And Economic Polarization, Hospital Of Delivery, And Severe Maternal Morbidity	59
Staffing Up For The Surge: Expanding The New York City Public Hospital Workforce During The COVID-19 Pandemic	59
The COVID-19 Innovation System	58
Return On Investment From Immunization Against 10 Pathogens In 94 Low- And Middle-Income Countries, 2011–30	58
Racial Disparities In Excess All-Cause Mortality During The Early COVID-19 Pandemic Varied Substantially Across States	57
Growth In Medicare Advantage Greatest Among Black And Hispanic Enrollees	55
Nurse Employment During The First Fifteen Months Of The COVID-19 Pandemic	51
Mortality Rates From COVID-19 Are Lower In Unionized Nursing Homes	49
US Physicians’ Knowledge About The Americans With Disabilities Act And Accommodation Of Patients With Disability	49
Medicaid Expansion Improved Perinatal Insurance Continuity For Low-Income Women	48
Unmet Social Needs And Worse Mental Health After Expiration Of COVID-19 Federal Pandemic Unemployment Compensation	47
Neonatal Abstinence Syndrome In The United States, 2004–16	46
Estimated Mortality Increases During The COVID-19 Pandemic By Socioeconomic Status, Race, And Ethnicity	46
Transforming Mental Health And Addiction Services	46
Reflections On Governance, Communication, And Equity: Challenges And Opportunities In COVID-19 Vaccination	46
Racism Runs Through It: Examining The Sexual And Reproductive Health Experience Of Black Women In The South	46
Medicaid Expansion Increased Preconception Health Counseling, Folic Acid Intake, And Postpartum Contraception	45
Infectious Disease Threats: A Rebound To Resilience	45
Comparing Medicare Advantage And Traditional Medicare: A Systematic Review	45
Female Physicians Earn An Estimated $2 Million Less Than Male Physicians Over A Simulated 40-Year Career	44
Impact Of Long-Term Buprenorphine Treatment On Adverse Health Care Outcomes In Medicaid	44
Buprenorphine Treatment By Primary Care Providers, Psychiatrists, Addiction Specialists, And Others	44
The Case Against Labor-Tax-Financed Social Health Insurance For Low- And Low-Middle-Income Countries	43
Many Medicare Beneficiaries Do Not Fill High-Price Specialty Drug Prescriptions	42
Informal And Formal Home Care For Older Adults With Disabilities Increased, 2004–16	41
Income Disparities In Access To Critical Care Services	41
The ACA Medicaid Expansion And Perinatal Insurance, Health Care Use, And Health Outcomes: A Systematic Review	40
Analysis Suggests Government And Nonprofit Hospitals’ Charity Care Is Not Aligned With Their Favorable Tax Treatment	40
State Policies That Treat Prenatal Substance Use As Child Abuse Or Neglect Fail To Achieve Their Intended Goals	39
The Mutually Reinforcing Cycle Of Poor Data Quality And Racialized Stereotypes That Shapes Asian American Health	38
Pathways To Equitable And Antiracist Maternal Mental Health Care: Insights From Black Women Stakeholders	38
Medicaid Physician Fees Remained Substantially Below Fees Paid By Medicare In 2019	37
How New Models Of Vaccine Development For COVID-19 Have Helped Address An Epic Public Health Crisis	37

Private Equity Investments In Health Care: An Overview Of Hospital And Health System Leveraged Buyouts, 2003–17	37
Immigrant Essential Workers Likely Avoided Medicaid And SNAP Because Of A Change To The Public Charge Rule	37
The Growth Of Private Equity Investment In Health Care: Perspectives From Ophthalmology	36
Private Equity In Dermatology: Effect On Price, Utilization, And Spending	36
Health Costs And Financing: Challenges And Strategies For A New Administration	36
Racial/Ethnic Differences In COVID-19 Screening, Hospitalization, And Mortality In Southeast Wisconsin	35
Adding A Climate Lens To Health Policy In The United States	35
Practice And Policy Reset Post-COVID-19: Reversion, Transition, Or Transformation?	35
Post-ACA, More Than One-Third Of Women With Prenatal Medicaid Remained Uninsured Before Or After Pregnancy	34
Advance Care Planning For Medicare Beneficiaries Increased Substantially, But Prevalence Remained Low	34
The Problem Of The Color Line: Spatial Access To Hospital Services For Minoritized Racial And Ethnic Groups	33
Improving Birth Outcomes And Lowering Costs For Women On Medicaid: Impacts Of ‘Strong Start For Mothers And Newborns’	33
Contributions Of Public Health, Pharmaceuticals, And Other Medical Care To US Life Expectancy Changes, 1990-2015	33
Medicare Beneficiaries In Disadvantaged Neighborhoods Increased Telemedicine Use During The COVID-19 Pandemic	33
Trends In Outpatient Mental Health Services Use Before And During The COVID-19 Pandemic	33
Training Clinical And Public Health Leaders In Climate And Health	32
US Public Health Neglected: Flat Or Declining Spending Left States Ill Equipped To Respond To COVID-19	32
Receipt Of Home-Based Medical Care Among Older Beneficiaries Enrolled In Fee-For-Service Medicare	32
SNAP Participants Improved Food Security And Diet After A Full-Service Supermarket Opened In An Urban Food Desert	31
Larger Nursing Home Staff Size Linked To Higher Number Of COVID-19 Cases In 2020	31
Varying Trends In The Financial Viability Of US Rural Hospitals, 2011–17	31
Community Workers Lend Human Connection To COVID-19 Response	30
The Intellectual Roots Of Current Knowledge On Racism And Health: Relevance To Policy And The National Equity Discourse	30
Developing A Definition Of Climate And Health Literacy	30
The Association Between COVID-19 Mortality And The County-Level Partisan Divide In The United States	30
Variation In State Medicaid Implementation Of The ACA: The Case Of Concurrent Care For Children	30
Health Care Spending And Use Among Hispanic Adults With And Without Limited English Proficiency, 1999–2018	30
Incorrect Provider Directories Associated With Out-Of-Network Mental Health Care And Outpatient Surprise Bills	29
Effects Of The 2021 Expanded Child Tax Credit On Adults’ Mental Health: A Quasi-Experimental Study	29
The Exodus Of State And Local Public Health Employees: Separations Started Before And Continued Throughout COVID-19	29
Lessons From The Impact Of Price Regulation On The Pricing Of Anticancer Drugs In Germany	29
The Association Of A Sweetened Beverage Tax With Changes In Beverage Prices And Purchases At Independent Stores	29
Pandemic Fatigue: The Effects Of The COVID-19 Crisis On Public Trust And Compliance With Regulations In Israel	29
Income-Related Inequality In Affordability And Access To Primary Care In Eleven High-Income Countries	29
Using Detection And Attribution To Quantify How Climate Change Is Affecting Health	29
COVID-19 Mortality Rates Among Nursing Home Residents Declined From March To November 2020	29
Sick And Tired Of Being Excluded: Structural Racism In Disenfranchisement As A Threat To Population Health Equity	29
COVID-19 Has Increased Medicaid Enrollment, But Short-Term Enrollment Changes Are Unrelated To Job Losses	29
Consideration Of Value-Based Pricing For Treatments And Vaccines Is Important, Even In The COVID-19 Pandemic	29
Veterans’ Experiences With Outpatient Care: Comparing The Veterans Affairs System With Community-Based Care	28
Nursing Home Staffing Levels Did Not Change Significantly During COVID-19	28
Chilling Effects: US Immigration Enforcement And Health Care Seeking Among Hispanic Adults	28
Health Care Sustainability Metrics: Building A Safer, Low-Carbon Health System	28
How Indigenous Communities Are Adapting To Climate Change: Insights From The Climate-Ready Tribes Initiative	28
Coping With Trauma, Celebrating Life: Reinventing Patient And Staff Support During The COVID-19 Pandemic	28
Clinicians With High Socially At-Risk Caseloads Received Reduced Merit-Based Incentive Payment System Scores	28
Primary Care Providers And Specialists Deliver Comparable Buprenorphine Treatment Quality	27
Worse Cardiac Arrest Outcomes During The COVID-19 Pandemic In Boston Can Be Attributed To Patient Reluctance To Seek Care	27
Out Of Reach: Inequities In The Use Of High-Quality Home Health Agencies	27
Most Patients Undergoing Ground And Air Ambulance Transportation Receive Sizable Out-Of-Network Bills	27
Food Insecurity Is Associated With Higher Health Care Use And Costs Among Canadian Adults	27
Optimizing Health And Well-Being For Women And Children	27
National Health Care Spending In 2021: Decline In Federal Spending Outweighs Greater Use Of Health Care	26
Informal Caregivers Provide Considerable Front-Line Support In Residential Care Facilities And Nursing Homes	26
Risk And Resilience Factors Influencing Postpartum Depression And Mother-Infant Bonding During COVID-19	26
Fewer Than Half Of US Mental Health Treatment Facilities Provide Services For Children With Autism Spectrum Disorder	26
In Medicaid Managed Care Networks, Care Is Highly Concentrated Among A Small Percentage Of Physicians	26
Deconstructing The Rise In Mental Health–Related ED Visits Among Children And Youth In Ontario, Canada	26
An Overview Of Vaccine Development, Approval, And Regulation, With Implications For COVID-19	26
Meta-Analysis Of Antenatal Depression And Adverse Birth Outcomes In US Populations, 2010–20	26
Adjusting Quality Measures For Social Risk Factors Can Promote Equity In Health Care	26
Using Information Technology To Improve COVID-19 Care At New York City Health + Hospitals	26
The Effectiveness Of Government Masking Mandates On COVID-19 County-Level Case Incidence Across The United States, 2020	26
Use Of Area-Based Socioeconomic Deprivation Indices: A Scoping Review And Qualitative Analysis	25
Ensuring Equitable Access To COVID-19 Vaccines In The US: Current System Challenges And Opportunities	25
Cultural And Structural Features Of Zero-Burnout Primary Care Practices	25
Structural Racism And Black Women’s Employment In The US Health Care Sector	25
COVID-19 Mortality At The Neighborhood Level: Racial And Ethnic Inequalities Deepened In Minnesota In 2020	25
National Trends In ED Visits, Hospital Admissions, And Mortality For Medicare Patients During The COVID-19 Pandemic	25
The Potential For Bias In Machine Learning And Opportunities For Health Insurers To Address It	24
A Survey Of Health Information Exchange Organizations In Advance Of A Nationwide Connectivity Framework	24
Policy Opportunities To Improve Prevention, Diagnosis, And Treatment Of Perinatal Mental Health Conditions	24
Family Care Availability And Implications For Informal And Formal Care Used By Adults With Dementia In The US	24
Higher Medicare Spending On Imaging And Lab Services After Primary Care Physician Group Vertical Integration	24
Associations Between Individual Demographic Characteristics And Involuntary Health Care Delays As A Result Of COVID-19	24
Financial Integration’s Impact On Care Delivery And Payment Reforms: A Survey Of Hospitals And Physician Practices	24
Increased Intensity Of PCR Testing Reduced COVID-19 Transmission Within Countries During The First Pandemic Wave	23
Mitigating Health Disparities After Natural Disasters: Lessons From The RISK Project	23
Association Of Neighborhood Disadvantage With Racial Disparities In COVID-19 Positivity In Chicago	23
Provider Teams Outperform Solo Providers In Managing Chronic Diseases And Could Improve The Value Of Care	23

Disparities In County COVID-19 Vaccination Rates Linked To Disadvantage And Hesitancy	23
Direct-To-Consumer Telemedicine Visits For Acute Respiratory Infections Linked To More Downstream Visits	23
Mental Health Conditions Increase Severe Maternal Morbidity By 50 Percent And Cost $102 Million Yearly In The United States	22
Medicare’s New Patient Driven Payment Model Resulted In Reductions In Therapy Staffing In Skilled Nursing Facilities	22
Quantifying The Economic Burden Of Drug Utilization Management On Payers, Manufacturers, Physicians, And Patients	22
Addressing The Interlocking Impact Of Colonialism And Racism On Filipinx/a/o American Health Inequities	22
Adolescent Exposure To Deadly Gun Violence Within 500 Meters Of Home Or School: Ethnoracial And Income Disparities	22
Social Determinants Matter For Hospital Readmission Policy: Insights From New York City	22
The Generational Impact Of Racism On Health: Voices From American Indian Communities	22
Health Policy Challenges Posed By Shifting Demographics And Health Trends Among Immigrants To The United States	22
Pressured By Students, Medical Schools Grapple With Climate Change	21
Deaths Of Despair: Adults At High Risk For Death By Suicide, Poisoning, Or Chronic Liver Disease In The US	21
Frequency Of Indirect Billing To Medicare For Nurse Practitioner And Physician Assistant Office Visits	21
Social Vulnerability And Outcomes For Access-Sensitive Surgical Conditions Among Medicare Beneficiaries	21
Despite The FDA’s Five-Year Plan, Black Patients Remain Inadequately Represented In Clinical Trials For Drugs	21
Medicaid Expansion Increased Medications For Opioid Use Disorder Among Adults Referred By Criminal Justice Agencies	21
Variation In The Effectiveness Of Collaborative Care For Depression: Does It Matter Where You Get Your Care?	21
Treatment Of Opioid Use Disorder Among Commercially Insured US Adults, 2008–17	21
Avoidable Hospitalizations And Observation Stays: Shifts In Racial Disparities	20
Cognitive Assessment At Medicare’s Annual Wellness Visit In Fee-For-Service And Medicare Advantage Plans	20
The Neighborhood Atlas Area Deprivation Index For Measuring Socioeconomic Status: An Overemphasis On Home Value	20
Reductions In Hospitalizations Among Children Referred To A Primary Care–Based Medical-Legal Partnership	20
Delayed Medical Care And Unmet Care Needs Due To The COVID-19 Pandemic Among Adults With Disabilities In The US	20
Privately Insured Transgender People Are At Elevated Risk For Chronic Conditions Compared With Cisgender Counterparts	20
The Impact Of Medicare On Access To And Affordability Of Health Care	20
Race, Place, And Structural Racism: A Review Of Health And History In Washington, D.C.	20
Changes In Coverage And Access To Dental Care Five Years After ACA Medicaid Expansion	20
Video Telemedicine Experiences In COVID-19 Were Positive, But Physicians And Patients Prefer In-Person Care For The Future	20
Admission Practices And Cost Of Care For Opioid Use Disorder At Residential Addiction Treatment Programs In The US	20
US Sick Leave In Global Context: US Eligibility Rules Widen Inequalities Despite Readily Available Solutions	20
Excluding People With Disabilities From Clinical Research: Eligibility Criteria Lack Clarity And Justification	20
Estimating The Costs Of Inaction And The Economic Benefits Of Addressing The Health Harms Of Climate Change	19
Medicaid Work Requirements In Arkansas: Two-Year Impacts On Coverage, Employment, And Affordability Of Care	19
Urgent Care Centers Deter Some Emergency Department Visits But, On Net, Increase Spending	19
The Effect Of Clinician Feedback Interventions On Opioid Prescribing	19
Assessing The Effectiveness Of Peer Comparisons As A Way To Improve Health Care Quality	19
A Phone Call Away: New York’s Hotline And Public Health In The Rapidly Changing COVID-19 Pandemic	19
Advancing Health Equity And Reducing Health Disparities For People With Disabilities In The United States	19
Workforce Composition In Private Equity–Acquired Versus Non–Private Equity–Acquired Physician Practices	19
Phantom Networks: Discrepancies Between Reported And Realized Mental Health Care Access In Oregon Medicaid	19
Children’s Health Insurance Coverage: Progress, Problems, And Priorities For 2021 And Beyond	19
Controversy Over Using Quality-Adjusted Life-Years In Cost-Effectiveness Analyses: A Systematic Literature Review	19
Trends In Residential Setting And Hospice Use At The End Of Life For Medicare Decedents	19
Trends In Self-Pay Charges And Insurance Acceptance For Abortion In The United States, 2017–20	19
Building Community Power To Dismantle Policy-Based Structural Inequity In Population Health	18
Wide State-Level Variation In Commercial Health Care Prices Suggests Uneven Impact Of Price Regulation	18
The COVID-19 Shadow Pandemic: Meeting Social Needs For A City In Lockdown	18
Thousands Of Lives Could Be Saved In The US During The COVID-19 Pandemic If States Exchanged Ventilators	18
Use Of And Willingness To Use Video Telehealth Through The COVID-19 Pandemic	18
Perinatal Mental Health Care In The United States: An Overview Of Policies And Programs	18
Switching Between Medicare Advantage And Traditional Medicare Before And After The Onset Of Functional Disability	18
Among Low-Income Women In San Francisco, Low Awareness Of Paid Parental Leave Benefits Inhibits Take-Up	18
Restoring An Inclusionary Safety Net For Children In Immigrant Families: A Review Of Three Social Policies	18
Enlisting Mental Health Workers, Not Cops, In Mobile Crisis Response	18
Designing Pull Funding For A COVID-19 Vaccine	17
Cost-Effectiveness Of A Workplace Ban On Sugar-Sweetened Beverage Sales: A Microsimulation Model	17
Health-Related Social Needs Among Older Adults Enrolled In Medicare Advantage	17
Provider Compliance With Kentucky’s Prescription Drug Monitoring Program’s Mandate To Query Patient Opioid History	17
Pediatric Drug Policies Supporting Safe And Effective Use Of Therapeutics In Children: A Systematic Analysis	17
Trust In US Federal, State, And Local Public Health Agencies During COVID-19: Responses And Policy Implications	17
Rapid Growth Of Remote Patient Monitoring Is Driven By A Small Number Of Primary Care Providers	17
Spending For Orphan Indications Among Top-Selling Orphan Drugs Approved To Treat Common Diseases	16
Changes In Non-COVID-19 Emergency Department Visits By Acuity And Insurance Status During The COVID-19 Pandemic	16
Home Health And Postacute Care Use In Medicare Advantage And Traditional Medicare	16
Reimagining Perinatal Mental Health: An Expansive Vision For Structural Change	16
A Content Analysis Of US Sanctuary Immigration Policies: Implications For Research In Social Determinants Of Health	16
National Health Expenditure Projections, 2021–30: Growth To Moderate As COVID-19 Impacts Wane	16
Home-Based Care Reimagined: A Full-Fledged Health Care Delivery Ecosystem Without Walls	16
The Relationship Between States’ Staffing Regulations And Hospitalizations Of Assisted Living Residents	16
Biosimilars And Follow-On Products In The United States: Adoption, Prices, And Users	16
Prenatal Substance Use Policies And Infant Maltreatment Reports	16
The Health Effects Of Expanding The Earned Income Tax Credit: Results From New York City	16
Management Of Chronic Noncommunicable Diseases After Natural Disasters In The Caribbean: A Scoping Review	16
What Is The Value Of A Star When Choosing A Provider For Total Joint Replacement? A Discrete Choice Experiment	15
Barriers To US Biosimilar Market Growth: Lessons From Biosimilar Patent Litigation	15
Extended Postpartum Medicaid Eligibility Is Associated With Improved Continuity Of Coverage In The Postpartum Year	15
The Links Between Disability, Incarceration, And Social Exclusion	15
Olive Garden’s Expansion Of Paid Sick Leave During COVID-19 Reduced The Share Of Employees Working While Sick	15
Health Benefits In 2020: Premiums In Employer-Sponsored Plans Grow 4 Percent; Employers Consider Responses To Pandemic	15
Patterns Of Food Security And Dietary Intake During The First Half Of The Child Tax Credit Expansion	15
Medicaid Coverage ‘Cliff’ Increases Expenses And Decreases Care For Near-Poor Medicare Beneficiaries	15
Racial And Ethnic Disparities In COVID-19 Booster Uptake	15
Principles And Policies To Strengthen Child And Adolescent Health And Well-Being	15
Using Email And Letters To Reduce Choice Errors Among ACA Marketplace Enrollees	14
A Social-Return-On-Investment Analysis Of Bon Secours Hospital’s ‘Housing For Health’ Affordable Housing Program	14
Value-Based Payment Models In The Commercial Insurance Sector: A Systematic Review	14
Adult Primary Care Physician Visits Increasingly Address Mental Health Concerns	14
Medicaid Expansion Led To Reductions In Postpartum Hospitalizations	14
Title X Improved Access To Most Effective And Moderately Effective Contraception In US Safety-Net Clinics, 2016–18	14
Out-Of-Network Spending Mostly Declined In Privately Insured Populations With A Few Notable Exceptions From 2008 To 2016	14
Medicaid Expansion: Effects On Hospital Finances And Implications For Hospitals Facing COVID-19 Challenges	14
Universal Health Coverage: Are Older Adults Being Left Behind? Evidence From Aging Cohorts In Twenty-Three Countries	14
Medicaid Expansion Associated With Some Improvements In Perinatal Mental Health	14
Food Insecurity Was Associated With Greater Family Health Care Expenditures In The US, 2016–17	14
Children’s Oral Health: Progress, Policy Development, And Priorities For Continued Improvement	14