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| Foreword | |
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| Preface | |
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| Acknowledgments | |
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| Introduction | |
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| A Brief Recap of the History of Reform | |
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| Early Reform Efforts | |
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| Tax Deductibility of Health Insurance | |
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| The Great Society: Medicare and Medicaid | |
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| The 1970s: Medicare HMOs and ERISA | |
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| Regulation: The Anti-Kickback Statute | |
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| Prospective Payment Systems | |
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| The 1990s | |
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| Rise of Managed Care | |
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| The Stark Law: Anti-Referral Statute | |
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| Balanced Budget Act of 1997 | |
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| Balanced Budget Revision Act and Benefits Improvement and Protection Act | |
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| Failure of Managed Care | |
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| Provider Integration and Consolidation | |
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| Summary of the Healthcare Market in 2000 | |
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| The New Century | |
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| One Size Fits All? Geographic Disparities in the U.S. Healthcare System | |
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| Profit and Nonprofit Hospitals and Health Insurers | |
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| History of Blue Plans | |
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| Medicare: The Other White Meat | |
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| Other Market-Based Studies | |
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| Geo-Clinical Differences | |
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| Summary | |
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| Massachusetts | |
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| The Time Line of Massachusetts Reform | |
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| Early Reform Legislation in Massachusetts | |
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| Acts of 1996 | |
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| Targeting the Small Group Market | |
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| Targeting the Trade Associations Offering Health Insurance to their Members | |
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| The Intervening Years | |
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| Components of the 2006 Massachusetts Legislation | |
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| Merging the Small Group and Individual Markets | |
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| Commonwealth Care Subsidies | |
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| Key Features of Massachusetts Reform | |
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| Recounting the Results of Reform in Massachusetts | |
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| Universal Coverage | |
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| Response of the Healthcare Provider Community | |
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| Differing Views of Massachusetts Reform | |
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| Special Commission on the Health Care Payment System | |
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| The Alternative Quality Contract | |
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| State Government Reports Tracking the Results of Reform | |
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| The Small Group and Individual Market versus Self-Insured Market | |
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| Massachusetts Quarterly Reports | |
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| Massachusetts Attorney General�s Report | |
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| Similar Experience in Other Markets | |
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| Specific Comparisons | |
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| Take from the Poor and Give to the Rich? | |
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| Impact on Market Share of Financially Weaker Providers | |
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| Most Favored Nation Clauses | |
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| Tiered Pricing | |
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| Recent Legislative Changes through August 2010 | |
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| Open Hearings in December 2009 | |
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| August 2010 Changes in Massachusetts | |
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| Open Enrollment | |
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| Review of Premium Increases | |
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| Tiered Network Requirement | |
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| What CanWe Learn from the Massachusetts Experience? | |
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| Insurance Reforms | |
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| What is Insurance? | |
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| Components of Health Insurance and Healthcare Entitlement | |
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| Sources of Coverage | |
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| Medicare | |
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| Medicaid | |
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| Self-Insured Employers | |
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| Small Group (Small Business) Insureds | |
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| Individual Insureds | |
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| Large Group�Business Not Self-Insuring | |
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| Selected Legislative Text for Insurance Exchanges | |
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| CMS Proposed Regulations�Glossary of Health Insurance and Medical Terms | |
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| Using the Massachusetts Health Connector | |
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| Medicare Advantage Plans | |
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| PPACA Sections Affecting Medicare Advantage | |
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| Table of Medicaid Provisions in the PPACA | |
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| Subtitle D�Medicare Part D Improvements for Prescription Drug Plans and MA-PD Plans | |
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| Example: Singl | |