In , high and rising health care spending called into question the sustainability of these reforms. Massachusetts prepared to implement its second wave of changes, which included delivery system reforms and a proposed shift from fee-for-service to "global payments" covering all or most of an individual's care. The case examines the content and sequencing of both phases of health care reform in Massachusetts, enabling discussion of health care system-level strategy and the relationship between coverage, care delivery, and spending.
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