Health Care Expenditures in the National Health Expenditures Accounts and in Gross Domestic Product: A Reconciliation

This paper provides a most detailed reconciliation to date of the National Health Expenditure Accounts (NHEA), the official estimates of health care spending in the United States from the Centers for Medicare and Medicaid Services (CMS), and the estimates of health expenditures that are part of gross domestic product (GDP) produced by the Bureau of Economic Analysis (BEA) as part of the national income and product accounts (NIPAs). For the period from 1997-2008, the estimates of total national health spending in the NHEA and in the GDP data are relatively similar, differing by less than 2 percent annually. Well over 90 percent of the total estimated expenditures in the two accounts appear to consist of the same expenditures. The differences in the estimates of expenditures for specific categories of health care – physician services, hospitals, drugs, health insurance, investment in equipment, and government programs – are, however, proportionately larger. The differences in the estimates of spending for specific categories of health care partly reflect differences in the way CMS and BEA classify certain healthrelated expenditures that are included in both accounts. The differences in the two estimates of health care spending also reflect some differences in the composition of health care spending in the two accounts, the use of some different estimation methods, and the use of some different data sources.

Games in Agriculture, Food, and Natural Resources Education

Educational games provide learners with team-based, experiential, and problem-centered learning opportunities. Therefore, educational games are recommended to encourage learner success in an increasingly complex and collaborative world. Research exploring interventions to increase teacher affinity toward games is needed to inform expansion of games within classrooms. The current study leveraged the input, environment, and outcomes model to analyze perceptions of games held by school-based agriculture, food, and natural resources (AFNR) educators before and after a professional development experience focused on educational games. Results indicate teachers held a favorable perception of games before engaging in the professional development. Engagement in the professional development was related to only minimal increases in the perceptions held by teachers regarding educational games. Importantly, individual items within the construct illuminate an expanded view of educational games and their utility within AFNR classrooms as a result of the professional development experience. Specifically, respondents saw educational games as being valuable to engage learners in new content, not just as a review tool. Findings suggest a professional development experience related to games may help expand teacher conceptualizations of educational game utility. Specific recommendations are included to expand teacher understanding and use of educational games

2020 Oklahoma Replicated Agronomic Cotton Evaluation (RACE) trial report

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