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The law, enacted in April 2006, is intended to increase health insurance coverage through a combination of Medicaid expansions, government subsidies, health insurance market reforms, and a requirement that individuals purchase health insurance coverage if affordable coverage is available .
Three Approaches to Health Care Reform Public Single Payer Approach: Expanded and Improved Medicare for All (HR676) Private Republican Party Approach: Individual Responsibility (Youre On Your Own) Public-private mix Democratic Party Approach: Private Insurance, Public Option Mandates.
Massachusetts had several advantages as it approached reform, including a relatively high percentage of the population that already had coverage, an uncompensated care pool that could be converted to dollars for coverage, and the ability of a Republican governor and Democratic legislature to work constructively
Reforms also emphasize strengthening Service Delivery Networks through a.o. gatekeeping through general practitioners and family physicians, increasing compliance with clinical practice guidelines and providing health services closer to people through use of mobile clinics, subsidies to patient transport costs and the
Reforms are assessed ing to their impact on the following policy goals: ensuring access to needed health-care services; improving the quality of health care and its outcomes; allocating an appropriate level of pubic sector and economy-wide resources to health care (macroeconomic efficiency); and ensuring that

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Key Findings: States may pursue a variety of strategies to control spending growth, ranging from promoting competition, reducing prices through regulation, and designing incentives to reduce the utilization of low-value care to more holistic policies such as imposing spending targets and promoting payment reform.
Based on the identified studies, we can conclude that the lack of administrative coordination related to stewardship, insufficient human resources related to creating resource, a lack of financial support related to financing, and unregulated and fragmented healthcare delivery systems related to delivering services
Under reform, uninsurance in Massachusetts dropped by more than 50%, due, in part, to an increase in employer-sponsored coverage. Gains in health care access and affordability were widespread, including a 28% decline in unmet need for doctor care and a 38% decline in high out-of-pocket costs.

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