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Introduction to Health Economics and Managed Care | |
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Fundamental Principles of Health Care Economics | |
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U.S. Health Care Economy | |
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Markets | |
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Efficiencies | |
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Production Possibilities Curve | |
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Demand | |
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Demand Shifters | |
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Utility | |
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Elasticities | |
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Supply | |
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Supply Shifters | |
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Profit Maximization | |
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Equilibrium and Disequilibrium | |
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Market Failures | |
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Market Power | |
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Information and Rational Decision-Making Problems | |
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Public Goods and Externalities | |
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Health Care Labor Markets | |
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Health Care Labor Demand Shifters | |
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Health Care Labor Supply Shifters | |
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Health Care Labor Market Failures | |
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Is Health Care "Different?" | |
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Conclusion | |
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Fundamentals of Insurance and Managed Care | |
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Health Insurance History and Principles | |
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Historic Foundations of Health Insurance | |
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Principles of Health Insurance | |
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Capitation And Managed Care | |
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Historic Foundations of Managed Care | |
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Principles of Managed Care | |
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Specialty Managed Care | |
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Conclusion | |
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Financial Reporting in Managed Care Settings | |
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Pine Tree Medical Group | |
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Overall Primary Care Utilization and Financial Data | |
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Overall Primary Care Financial Indicators | |
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Primary Care Utilization and Financial Data and Indicators by PCP | |
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Overall Specialty Care Utilization and Financial Data | |
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Specialty Care Data and Indicators by PCP and by Specialist | |
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Inpatient Utilization and Costs by PCPs | |
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Comparison of Data and Indicators over Time | |
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Conclusion | |
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Budgets, Budget Monitoring, and Budget Preparation | |
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Types and Components of Budgets | |
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Budgets as Descriptions | |
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Budget Components | |
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Types of Budgets | |
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Statistics Budget | |
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Operating Budget | |
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Capital Budget | |
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Cash Flow Budget | |
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Other Budgets | |
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Conclusion | |
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Budget Monitoring and Control | |
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Monitoring Budgets | |
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Variance Analysis | |
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Budget Control | |
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Conclusion | |
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Budget Preparation | |
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Factors in Budget Preparation | |
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Budget Cycle and Strategic Plan | |
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Operating Budget Preparation | |
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Incremental Budgeting | |
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Forecasting | |
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Variance Analysis and Budget Preparation | |
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Fixed and Flexible Non-Personnel Expenses | |
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Fixed and Flexible Personnel Expenses | |
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Revenue Budgeting and Budget Balancers | |
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Budgeting for New Line Items | |
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Preparing the Capital Budget | |
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Preparing the Cash Flow Budget | |
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Additional Budget Preparation Concepts | |
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"What-if" Calculations | |
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Step-fixed FTEs and Budgeting | |
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Zero-Base Budgeting | |
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Closing a Program | |
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Conclusion | |
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Cost Allocation and Cost-Finding | |
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Cost Centers and Cost Drivers | |
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Cost Drivers | |
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Direct Distribution Cost Allocation and Cost-Finding | |
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Overhead Rate Method of Direct Distribution | |
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Cost Pool Method of Direct Distribution | |
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Other Cost Allocation Methods | |
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Classification and Weighted Approaches to Costing Services | |
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Other Cost-Finding Methods | |
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Monitoring and Preparing Cost Reports | |
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Conclusion | |
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Financial Analysis Tools | |
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Break-Even Analysis | |
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Break-Even Without Profit | |
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Volume | |
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Costs | |
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Revenue | |
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The Break-even Principle and Formula | |
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Keeping Costs within Budget | |
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When Reimbursement Is Set | |
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Using Break-Even Analysis to Set the Price | |
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Break-even with Profit | |
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Break-even Volume to Generate a Profit Target | |
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Break-even Price to Generate a Profit Target | |
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Guidelines for Breaking Even | |
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Contribution Margin | |
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Unit Contribution Margin | |
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Contribution Margin and pro forma P&L Statements | |
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Complicating Factors in Breaking Even | |
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Break-Even in Capitation | |
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Conclusion | |
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Cost-Benefit Analysis and Cost-Effectiveness Analysis | |
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Cost-Benefit Analysis | |
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CBA Procedures | |
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Discounting, Discount Rate and Present Value | |
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Cost-Effectiveness Analysis and Procedures | |
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Valuing Human Life | |
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Quality-Adjusted Life Years | |
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Program Evaluation | |
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Limitations of CBA and CEA | |
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Conclusion | |
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Understanding and Using Financial Reports | |
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Basics of Financial Accounting and Reporting | |
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History and Regulation of Financial Reporting | |
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Measuring and Recording Financial Activities | |
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Time Periods | |
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Basis of Accounting | |
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Consistency and Conservatism | |
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Materiality | |
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Disclosure | |
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Financial statements | |
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The Annual Report | |
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The Income Statement | |
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The Balance Sheet | |
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The Statement of Cash Flows | |
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The Statement of Cash Flows, Balance Sheet, and Income Statement | |
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Conclusion | |
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Basic Financial Analysis | |
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Financial Statement Analysis | |
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Operating Leverage | |
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Percentage Change Analysis | |
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Common Size Analysis | |
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Ratio Analysis | |
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Operating Analysis | |
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Conclusion | |
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Applying Budgeting and Financial Analysis: Business Plans and Grant Proposals | |
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Writing a Business Plan | |
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Components of the Business Plan | |
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Problem or Need Identification | |
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Product Definition | |
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Market Analysis | |
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Budget Estimates | |
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Financial Analysis | |
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Timeline | |
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Conclusion and Feasibility Statement | |
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Conclusion | |
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Grant Writing: Getting Funding From an Outside Source | |
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Types Of Grant Proposals | |
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Purposes of Health Program Grant Proposals | |
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Other Types of Grants | |
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Funding Sources | |
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Key Components of Proposals | |
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Letter of Transmittal | |
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Items Promoting Clarity | |
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Proposal Introduction | |
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Problem Definition and Needs Assessment | |
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Documenting Need | |
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Objectives | |
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Program Description | |
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Resources and Resource Needs | |
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Budget and Explanation | |
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Evaluation Plan | |
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Capability Statement | |
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Plans for Future Funding | |
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Evaluating Proposals | |
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Grant Renewals | |
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Conclusion | |
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International Perspectives and Future Trends | |
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International Health Economics Issues | |
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Health Care Systems | |
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Economic Comparisons: Industrialized Nations | |
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Issues in Developing Nations | |
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Health Care Rationing | |
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Global Concerns | |
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Conclusion | |
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Future Trends and Keeping Updated | |
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Health Policy Questions | |
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Keeping Updated on Future Trends | |
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Future Trends | |
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Aging Population | |
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Health Care Labor Imbalances | |
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Growth in Technology Use | |
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Access to Health Care | |
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Medicare Reimbursement | |
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National Health Care Coverage | |
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Implications for Readers | |
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Conclusion | |
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Appendices | |
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Cost Benefit Analysis | |
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Cost Effectiveness Analysis | |
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Business Plan | |
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Grant Proposal | |
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Policy Question Worksheet | |
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Glossary | |
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Index | |