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How will COVID-19 change our schools in the long run?

In the midst of an unprecedented crisis, it can be hard to see more than a few days into the future. It’s as if we were wandering around in a dense (and deadly) fog. Some commentators are predicting that this will change the way we live; one even predicts that it will “change us as…

       




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Avoiding the COVID-19 slump: Making up for lost school time

In 1996, Harris Cooper of Duke University and his colleagues first reported on the effects of what came to be known as summer slide, or summer slump. Over the summer months, when children are not in school, those from under-resourced communities tend to lose roughly 30 percent of the gains they made in math during…

       




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During COVID-19, underperforming school districts have no excuse for standstill on student learning

During the COVID-19 pandemic, only 44% of school districts are both providing instruction online and monitoring students’ attendance and progress. Kids in these districts have a good chance of staying on grade-level during the coronavirus shutdown. Kids in the majority of districts, which are either providing no instruction or offering instruction but not tracking progress,…

       




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Supporting students and promoting economic recovery in the time of COVID-19

COVID-19 has upended, along with everything else, the balance sheets of the nation’s elementary and secondary schools. As soon as school buildings closed, districts faced new costs associated with distance learning, ranging from physically distributing instructional packets and up to three meals a day, to supplying instructional programming for television and distributing Chromebooks and internet…

       




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COVID-19 is hitting the nation’s largest metros the hardest, making a “restart” of the economy more difficult

The coronavirus pandemic has thrown America into a coast-to-coast lockdown, spurring ubiquitous economic impacts. Data on smartphone movement indicate that virtually all regions of the nation are practicing some degree of social distancing, resulting in less foot traffic and sales for businesses. Meanwhile, last week’s release of unemployment insurance claims confirms that every state is seeing a significant…

       




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Businesses owned by women and minorities have grown. Will COVID-19 undo that?

There are two small business crises in the United States. The first—the sudden shock to small businesses induced by COVID-19—is acute and immediate. Our recent analysis indicates that over 50% of small businesses with employees (an astounding 4 million establishments) face immediate or near-term risks due to the pandemic. The second crisis—the structural racial and…

       




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Redesign required: Principles for reimagining federal rural policy in the COVID-19 era

The COVID-19 crisis is testing America’s resilience. The rapidly accelerating economic fallout makes concrete the risks for a national economy built on the success of just a few key economic centers. When the nation turns to the work of recovery, our goal must be to expand the number and breadth of healthy communities, jump-starting a…

       




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COVID-19 | Rakesh Mohan on the Indian economy and battling the slowdown

       




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How the Sustainable Development Goals can help cities focus COVID-19 recovery on inclusion, equity, and sustainability

Prior to COVID-19, the Sustainable Development Goals (SDGs) were gaining traction among local governments and city leaders as a framework to focus local policy on ambitious targets around inclusion, equity, and sustainability. Several cities published reports of their local progress on the SDGs in Voluntary Local Reviews (VLR), echoing the official format used by countries…

       




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Global solutions to global ‘bads’: 2 practical proposals to help developing countries deal with the COVID-19 pandemic

In a piece written for this blog four years ago—after the Ebola outbreaks but mostly focused on rising natural disasters—I argued that to deal with global public “bads” such as climate change, natural disasters, diseases, and financial crises, we needed global financing mechanisms. Today, the world faces not just another global public bad, but one…

       




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Can public policy incentivize staying at home during COVID-19?

More than a quarter of the world’s people are in quarantine or lockdown in response to the coronavirus (COVID-19). Tens of millions are required to stay at home, with many of them laid off or on unpaid leave. Given the highly contagious nature of the virus and the absence of a vaccination or cure, the…

       




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Funding the development and manufacturing of COVID-19 vaccines: The need for global collective action

On February 20, the World Bank and the Coalition for Epidemic Preparedness Innovations (CEPI), which funds development of epidemic vaccines, cohosted a global consultation on funding the development and manufacturing of COVID-19 vaccines. We wrote a working paper to guide the consultation, which we coauthored with World Bank and CEPI colleagues. The consultation led to…

       




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Leveraging e-commerce in the fight against COVID-19

E-commerce—defined broadly as the sale of goods and services online—is emerging as a key pillar in the global fight against COVID-19. Online grocery shopping and telemedicine, for instance, are helping to avoid in-person contact and reduce the risk of new infections. Video chats, movie streaming, and online education make physical distancing measures more bearable. In…

       




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Hard times require good economics: The economic impact of COVID-19 in the Western Balkans

Like in other parts of the world, the Western Balkans are suffering a heavy blow as the novel coronavirus spreads. Governments are sending people home, and only a few businesses are allowed to operate. What began as a health shock has required a conscious—and necessary—temporary activity freeze to slow the spread of infection, leading to…

       




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COVID-19 has revealed a flaw in public health systems. Here’s how to fix it.

To be capable of surveilling, preventing, and managing disease outbreaks, public health systems require trustworthy, community-embedded public health workers who are empowered to undertake their tasks as professionals. The world has not invested in this cadre of health workers, despite the lessons from Ebola. In a new paper, my co-authors and I discuss why, and…

       




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The unreal dichotomy in COVID-19 mortality between high-income and developing countries

Here’s a striking statistic: Low-income and lower-middle income countries (LICs and LMICs) account for almost half of the global population but they make up only 2 percent of the global death toll attributed to COVID-19. We think this difference is unreal. Views about the severity of the pandemic have evolved a lot since its outbreak…

       




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Turning back the Poverty Clock: How will COVID-19 impact the world’s poorest people?

The release of the IMF’s World Economic Outlook provides an initial country-by-country assessment of what might happen to the world economy in 2020 and 2021. Using the methods described in the World Poverty Clock, we ask what will happen to the number of poor people in the world—those living in households with less than $1.90…

       




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How COVID-19 is changing law enforcement practices by police and by criminal groups

The COVID-19 outbreak worldwide is affecting not just crime as I explained last week, but also law enforcement: How are police responding to COVID-19 and its knock-on effects on crime? What effects does the pandemic have on criminal groups and the policing they do? Where have all the coppers gone? Globally, police forces are predominantly…

       




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Mexican cartels are providing COVID-19 assistance. Why that’s not surprising.

That Mexican criminal groups have been handing out assistance to local populations in response to the COVID-19 pandemic sweeping through Mexico has generated much attention. Among the Mexican criminal groups that have jumped on the COVID-19 “humanitarian aid” bandwagon are the Cartel Jalisco Nueva Generación (CJNG), the Sinaloa Cartel, Los Viagras, the Gulf Cartel, and…

       




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Podcast: Camille François on COVID-19 and the ABCs of disinformation

Camille François is a leading investigator of disinformation campaigns and author of the well-known "ABC" or "Actor-Behavior-Content" disinformation framework, which has informed how many of the biggest tech companies tackle disinformation on their platforms. Here, she speaks with Lawfare's Quinta Jurecic and Evelyn Douek for that site's series on disinformation, "Arbiters of Truth." Earlier this…

       




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US-Iran tensions escalate amid COVID-19

       




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Cuba’s forgotten eastern provinces

EXECUTIVE SUMMARY The five provinces of eastern Cuba (Oriente) have played central roles in the forging of the island’s history. In the 19th and early 20th centuries, sugarcane plantations generated fabulous wealth and Santiago de Cuba boasted a thriving middle class, even as most of the peasantry were relegated to grinding poverty and social neglect.…

       




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Cuba’s forgotten eastern provinces: Testing regime resiliency

       




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Webinar: COVID-19: Implications for peace and security in the Middle East

The Brookings Doha Center (BDC) hosted a webinar discussion on April 22, 2020 about the effects of the COVID-19 pandemic on peace and security in the Middle East and North Africa (MENA). Panelists assessed the short-term and long-term implications for the region at large whilst also narrowing in on Iraq and Syria. The panel consisted…

       




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A parent’s guide to surviving COVID-19: 8 strategies to keep children healthy and happy

For many of us, COVID-19 has completely changed how we work. Remote work might have its advantages for some, but when the kids are out of school and libraries and museums are closed, juggling two roles at once can be a challenge. What is a parent to do? As two developmental psychologists dedicated to understanding…

       




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Playful learning in everyday places during the COVID-19 crisis—and beyond

Under normal circumstances, children spend 80 percent of their waking time outside the classroom. The COVID-19 pandemic has quite abruptly turned that 80 percent into 100 percent. Across the U.S., schools and child care centers have been mandated to close, and children of all ages are now home full time. This leaves many families, especially…

       




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Businesses owned by women and minorities have grown. Will COVID-19 undo that?

There are two small business crises in the United States. The first—the sudden shock to small businesses induced by COVID-19—is acute and immediate. Our recent analysis indicates that over 50% of small businesses with employees (an astounding 4 million establishments) face immediate or near-term risks due to the pandemic. The second crisis—the structural racial and…

       




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How COVID-19 will change the nation’s long-term economic trends, according to Brookings Metro scholars

Will the coronavirus change everything? While that sentiment feels true to the enormity of the crisis, it likely isn’t quite right, as scholars from the Brookings Metropolitan Policy Program have been exploring since the pandemic began. Instead, the COVID-19 crisis seems poised to accelerate or intensify many economic and metropolitan trends that were already underway, with huge…

       




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COVID-19’s recent spread shifts to suburban, whiter, and more Republican-leaning areas

There is a stereotypical view of the places in America that COVID-19 has affected most: they are broadly urban, comprised predominantly of racial minorities, and strongly vote Democratic. This underlines the public’s perception of what kinds of populations reside in areas highly exposed to the coronavirus, as well as some of the recent political arguments…

       




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COVID-19 is expanding further into Trump country

The COVID-19 pandemic has already shown a dispersion away from the nation’s most urban and densely populated counties to suburban, somewhat whiter, and less politically Democratic parts of the country.  Yet the group of counties that newly qualify as areas with a high prevalence of COVID-19 cases are even more dispersed, and represent places where…

       




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Turning back the Poverty Clock: How will COVID-19 impact the world’s poorest people?

The release of the IMF’s World Economic Outlook provides an initial country-by-country assessment of what might happen to the world economy in 2020 and 2021. Using the methods described in the World Poverty Clock, we ask what will happen to the number of poor people in the world—those living in households with less than $1.90…

       




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As states reopen, COVID-19 is spreading into even more Trump counties

Even as the COVID-19 pandemic drags on, America has begun to open up for some business and limited social interaction, especially in parts of the country that did not bear the initial brunt of the coronavirus.  However, the number of counties where COVID-19 cases have reached “high-prevalence” status continues to expand. Our tracking of these…

       




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Americans give President Trump poor ratings in handling COVID-19 crisis

Since its peak in late March, public approval of President Trump’s handling of the COVID-19 pandemic has slowly but steadily declined. Why is this happening? Will his new guidelines to the states for reopening the country’s turn it around? What will be the impact of his latest tweets, which call on his supporters to “liberate”…

       




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How instability and high turnover on the Trump staff hindered the response to COVID-19

On Jan. 14, 2017, the Obama White House hosted 30 incoming staff members of the Trump team for a role-playing scenario. A readout of the event said, “The exercise provided a high-level perspective on a series of challenges that the next administration may face and introduced the key authorities, policies, capabilities, and structures that are…

       




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India’s coronavirus response, anti-China sentiment, and the communalization of Covid-19

       




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Webinar: Policing in the era of COVID-19

The consequences of the novel coronavirus pandemic stretch across the entirety of government services. Major police agencies have reported absentee rates as high as 20% due to officers who are either themselves afflicted with the virus or in need of self-quarantine. Reported crimes are generally down in America’s cities as a result of the many…

       




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How COVID-19 could push Congress to start reining in vulture capitalism

The effects of income inequality have been felt throughout society but they are especially evident in the current coronavirus crisis. For instance, workers in the information economy are able to telework and draw their salaries, but workers in the service sector are either unemployed or at great risk as they interact with customers during a…

       




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Improving the Medicare ACO Program: The Top Eight Policy Issues


There are now more than 335 Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) in 47 states, DC, and Puerto Rico. Early results show that most Medicare ACOs are succeeding at meeting their quality benchmarks, but only about a quarter of MSSP participants have been able to reduce their spending enough below projected financial targets to qualify for shared savings. While these results are encouraging, especially given the financial and practice transformation necessary to succeed as an ACO, they also suggest that more work is needed from both CMS and the providers to ensure continued sustainability of the MSSP ACOs.

Given that the first three year cycle of MSSP ends in 2015 and more providers will likely be entering the MSSP in the coming years , the Centers for Medicare and Medicaid Services (CMS) has indicated that they intend to release a Notice of Proposed Rulemaking (NPRM) that will establish the rule for participation in the Medicare ACO program. In anticipation of these coming changes, the Engelberg Center for Health Care Reform released an issue brief that identifies the "Top Eight ACO Challenges" to encourage further discussion and considerations for ensuring the continued success of ACOs. These potential policy alternatives build on discussions with ACO Learning Network members and other related stakeholders implementing accountable care across the country and include the following issues.

These issues, and many others, will be a focus of the discussions at the upcoming Fifth National ACO Summit later this week.

Top Eight Medicare ACO Challenges

1. Make Technical Adjustments to Benchmarks and Payments
In order for ACOs to qualify for shared savings, they must be able to hold spending below a financial benchmark set using historical spending patterns and meet a certain threshold of person and population-level quality metrics. A number of issues should be considered that affect the ACO’s chances of being able to attain shared savings and have more predictability about their performance: benchmark calculation methodology, how to adjust for regional variation in performance, and risk adjustment.

2. Transition to More Person-Based Payments
The ultimate goal of an ACO is to improve quality at the patient and population level and control the growth of health care costs. In order to successfully achieve this mission, ACOs must over time make a transition to payments that involve the assumption of more risk by the provider organization with a reward for better health outcomes for groups of patients. ACOs must have a clear transition path for increasing accountability and assumption of more risk for patient health outcomes.

3. Increase Beneficiary Engagement
Patients can play a critical role in helping to achieve the goals of an ACO. Health outcomes are determined by whether patients follow prescribed therapies. Increasing beneficiary engagement holds the potential to make patients more activated members of the ACO who can contribute to its success. A number of issues should be considered to improve beneficiary engagement, including adjusting attribution methods, creating more incentives for patients to seek care within the ACO, and finding opportunities to activate patients as part of the care team.

4. Enhance and Improve Alignment of Performance Measures
A central tenet of Medicare ACOs is delivering high quality health care as determined by performance on 33 measures established by CMS. ACOs must meet performance benchmarks in order to be eligible for shared savings, ensuring that these organizations are delivering high value, rather than simply cheaper, care. A number of barriers exist to achieving better performance measurement, including administrative burdens, lack of measure alignment among payers, lack of rewards for quality improvement, and concerns about measure selection.

5. Enable Better and More Consistent Supporting Data
In order to succeed as an ACO, organizations must be able to effectively collect, interpret, and use clinical and claims data to transform care of their patients. ACOs need to adopt new health IT systems and other technologies in order to collect and use the growing amount of data. ACOs currently struggle with reconciling data between different sources, dealing with patients who opt out of data sharing, lack of timeliness for receiving data, difficulty of tracking patients through the health system, and delays in performance feedback.

6. Link to Additional Value-Based Payment Reforms
ACOs are just one of many payment reforms that health care organizations across the country are implementing to improve quality and reduce costs. Aligning the vision and components of these other initiatives with ACO reforms has the potential to reinforce the shared goals and fundamentally change the health system. However, there are barriers to achieving this alignment such as lacks of linkages to bundled payments and other new payment models, multi-payer ACOs with different payment systems, and inability for organizations to participate in multiple CMS payment innovations.

7. Develop Bonus Payments and Other Incentives to Participate
In order to effectively transform clinical practice, ACOs must create or procure significant financial and human capital, as well as transform their information technology and delivery infrastructure. A recent survey estimates the average start-up cost for creating an ACO to be $2 million, with some ACOs investing significantly more in their first few years. Many ACOs, especially smaller ones, struggle to find sufficient start-up capital, are uncertain if they can assume the level of risk required for an ACO, and need significant staff and clinical change to effectively transform care.

8. Support Clinical Transformation
Becoming and succeeding as an ACO is a vast undertaking that requires immediately beginning to transform practice, finance, and operations. However, many providers, particularly those that are less experienced at systemic practice transformation, need more support in undertaking clinical transformation.

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COVID-19, Africans’ hardships in China, and the future of Africa-China relations

In the midst of the global scramble to deal with the COVID-19 crisis, relations have ruptured at a most unexpected front—between China and Africa. Since April 8, reports and social media discussions about the eviction and maltreatment of Africans in the Chinese city of Guangzhou have gone viral, leading to a series of formal and…

       




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Turkey and COVID-19: Don’t forget refugees

It has been more than a month since the first COVID-19 case was detected in Turkey. Since then, the number of cases has shot up significantly, placing Turkey among the top 10 countries worldwide in terms of cases. Government efforts have kept the number of deaths relatively low, and the health system so far appears…

       




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How instability and high turnover on the Trump staff hindered the response to COVID-19

On Jan. 14, 2017, the Obama White House hosted 30 incoming staff members of the Trump team for a role-playing scenario. A readout of the event said, “The exercise provided a high-level perspective on a series of challenges that the next administration may face and introduced the key authorities, policies, capabilities, and structures that are…

       




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Charts of the Week: Housing affordability, COVID-19 effects

In Charts of the Week this week, housing affordability and some new COVID-19 related research. How to lower costs of apartment building to make them more affordable to build In the first piece in a series on how improved design and construction decisions can lower the cost of building multifamily housing, Hannah Hoyt and Jenny…

       




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Putting women and girls’ safety first in Africa’s response to COVID-19

Women and girls in Africa are among the most vulnerable groups exposed to the negative impacts of the coronavirus pandemic. Although preliminary evidence from China, Italy, and New York shows that men are at higher risk of contraction and death from the disease—more than 58 percent of COVID-19 patients were men, and they had an…

       




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Africa in the news: Ethiopia, Eritrea, Sudan, COVID-19, and AfCFTA updates

Ethiopia, Eritrea, Sudan political updates Ethiopia-Eritrea relations continue to thaw, as on Sunday, May 3, Eritrean president Isaias Afwerki, Foreign Minister Osman Saleh, and Presidential Advisor Yemane Ghebreab, visited Ethiopia, where they were received by Prime Minister Abiy Ahmed. During the two-day diplomatic visit, the leaders discussed bilateral cooperation and regional issues affecting both states,…

       




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Meet the COVID-19 frontline heroes: Grocery workers

       




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The unemployment impacts of COVID-19: lessons from the Great Recession

Efforts to stop the spread of the novel coronavirus—particularly the closure of nonessential businesses—are having an unprecedented impact on the U.S. economy. Nearly 17 million people filed initial claims for unemployment insurance over the past three weeks, suggesting that the unemployment rate is already above 15 percent[1] —well above the rate at the height of…

       




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The next COVID-19 relief bill must include massive aid to states, especially the hardest-hit areas

Amid rising layoffs and rampant uncertainty during the COVID-19 pandemic, it’s a good thing that Democrats in the House of Representatives say they plan to move quickly to advance the next big coronavirus relief package. Especially important is the fact that Speaker Nancy Pelosi (D-Calif.) seems determined to build the next package around a generous infusion…

       




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Making sense of the monthly jobs report during the COVID-19 pandemic

The monthly jobs report—the unemployment rate from one survey and the change in employer payrolls from another survey—is one of the most closely watched economic indicators, particularly at a time of an economic crisis like today. Here’s a look at how these data are collected and how to interpret them during the COVID-19 pandemic. What…

       




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COVID-19 and school closures: What can countries learn from past emergencies?

As the COVID-19 pandemic spreads around the world, and across every state in the U.S., school systems are shutting their doors. To date, the education community has largely focused on the different strategies to continue schooling, including lively discussions on the role of education technology versus distribution of printed paper packets. But there has been…

       




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COVID-19 is a health crisis. So why is health education missing from schoolwork?

Nearly all the world’s students—a full 90 percent of them—have now been impacted by COVID-19 related school closures. There are 188 countries in the world that have closed schools and universities due to the novel coronavirus pandemic as of early April. Almost all countries have instituted nationwide closures with only a handful, including the United States, implementing…