This report is the 19th in a series of annual reports on recent trends in U.S. services trade that the U.S. International Trade Commission (the Commission or USITC) has published. The Commission also publishes an annual companion report on U.S. merchandise trade, Shifts in U.S. Merchandise Trade. These recurring reports are the product of an investigation instituted by the Commission in 1993 under section 332(b) of the Tariff Act of 1930. The information contained in this report reflects the knowledge, industry contacts, and analytic skills that are used by the Commission in providing expert analyses of service industries in its statutory investigations and in apprising its customers of global industry trends, regional developments, and competitiveness issues.