A Policy Initiative of the National Academy of Medicine

The National Academy of Medicine’s (NAM) Vital Directions for Health and Health Care policy initiative aims to provide incoming U.S. Presidential Administrations, as well as other policy makers, opinion leaders, and the public, with trusted, nonpartisan, evidence-based analysis of the most compelling opportunities and priorities in health, health care, and biomedical science. 

In anticipation of the 2016 Presidential election, the NAM saw a need for a trusted, independent, and objective source to: 1) call attention to the highest-priority issues in American health and health care; 2) compile expert, evidence-based insights and recommendations for policy and practice around each issue; and 3) strengthen bridges among policy makers and health experts to share information, foster consensus, and guide policy. The 2017 Vital Directions capstone publication presents a vision of an optimized health system, along with a streamlined framework—built on a core set of eight strategic action priorities and essential infrastructure needs identified by the Vital Directions Steering Committee.

Since the 2017 seminal publication, much has happened in health and health care, underscoring concerns about the nation’s persistent challenges related to maternal mortality, the opioid crisis, and pervasive health inequities, among others. In anticipation of the 2020 presidential election, the NAM completed an updated assessment on key priorities and issues of urgent attention for the next administration. 

Vital Directions for Health and Health Care: Priorities for 2021

With the NAM’s Congressionally-charted responsibility as advisor to the nation, the cycles of the presidential term offer the occasion for renewed assessment by the NAM of the nation’s opportunities and priorities in health and health care. In anticipation of the next four-year cycle, and as we moved from the 2017 Vital Directions seminal publication to the next phase of this initiative in 2020, the NAM undertook a more abbreviated, but important, updated assessment on key priorities and issues of urgent attention for the next Administration.

Building on the initial Vital Directions effort, the NAM marshaled guidance from over 30 experts to address five high priority issues that have a particularly compelling need for attention, with each article reviewing trends, analysis of the challenge, and potential actions. The collection of articles, published in Health Affairs in January 2021, also reflects experience with both the coronavirus disease 2019 (COVID-19) pandemic and the health inequities that have been drawn out sharply by COVID-19, as well as the implications going forward for action.

Read the Health Affairs articles below:

Download 1-page summaries: Vital Directions 2021 overview | Health Costs And Financing-Challenges And Strategies | Optimizing Health And Well-Being For Women And Children | Transforming Mental Health And Addiction Services | Actualizing Better Health And Health Care For Older Adults | Infectious Disease Threats: A Rebound To Resilience

Vital Directions for Health and Health Care: Priorities for 2017

Co-chaired by NAM President Victor J. Dzau and Mark McClellan, director of the Duke-Margolis Center for Health Policy, and guided by an 18-member bipartisan steering committee, the foundational Vital Directions for Health and Health Care effort drew on more than 150 experts  from across the country who authored expert, peer-reviewed papers with policy recommendations in 19 key areas important to three areas: better health and well-being, high-value health care, and strong science and technology. In addition, the Journal of the American Medical Association published summaries (or “Viewpoints”) of each paper.

The 2017 capstone publication, containing the Steering Committee’s synthesis along with the 19 discussion papers, presents a vision of an optimized health system together with a streamlined framework—built on a core set of eight strategic action priorities and essential infrastructure needs identified by the Vital Directions Steering Committee. Included are four action priorities—pay for value, empower people, activate communities, and connect care—that represent direct and strategic opportunities to advance a more efficient, equitable, and patient- and community-focused health system. Four essential infrastructure needs—measure what matters most, modernize skills, accelerate real-world evidence, and advance science—represent foundational elements for future progress.

As the nation continues to face growing challenges in health and health care—such as inequitable access and quality of care and increased spending—this framework provides expert guidance on many issues that continue to plague the United States, and can be used by decision-makers in implementing policy that addresses these concerns.

(*) – also supported the North Carolina Experience
Bold sponsors supported both 2017 and 2021 Vital Directions Initiatives

Disclaimer: The purpose of the Vital Directions for Health & Health Care initiative is to compile expert information and guidance about important directions for health and health care in the United States. The views presented in the Vital Directions papers are those of the authors and do not represent formal consensus positions of the NAM, the National Academies of Sciences, Engineering, and Medicine, or the authors’ organizations.