Synopsis and Overview |
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1 | (68) |
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Section I Excessive Healthcare Costs |
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1 The Healthcare Imperative |
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69 | (16) |
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Promoting Efficiency and Reducing Disparities in Health Care |
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72 | (4) |
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Why Americans Spend More for Health Care |
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76 | (9) |
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85 | (24) |
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86 | (9) |
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Regional Insights and U.S. Health Care Savings |
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95 | (6) |
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Opportunities to Reduce Unwarranted Care Differences |
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101 | (8) |
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3 Inefficiently Delivered Services |
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109 | (32) |
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Costs of Errors and Inefficiency in Hospitals |
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111 | (5) |
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Costs from Inefficient Use of Caregivers |
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116 | (9) |
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Costs from Physician Office Inefficiencies |
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125 | (4) |
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Low-Cost Hospitals with High-Quality Scores |
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129 | (12) |
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4 Excess Administrative Costs |
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141 | (34) |
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Excess Billing and Insurance-Related Administrative Costs |
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142 | (9) |
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What Does It Cost Physician Practices to Interact with Payers? |
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151 | (8) |
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Cost Savings from Simplifying the Billing Process |
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159 | (7) |
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Excess Health Insurance Administrative Expenses |
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166 | (9) |
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5 Prices That are Too High |
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175 | (44) |
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Price Implications of Hospital Consolidation |
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177 | (10) |
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187 | (10) |
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Durable Medical Equipment Prices |
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197 | (5) |
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Market Pricing and the Medicare Program |
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202 | (7) |
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209 | (10) |
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6 Missed Prevention Opportunities |
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219 | (22) |
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The Price Paid for Not Preventing Diseases |
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220 | (5) |
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Cost Savings from Primary and Secondary Prevention |
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225 | (7) |
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Tertiary Prevention and Treatment Costs |
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232 | (9) |
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Section II Strategies that Work |
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241 | (16) |
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Strategies That Work and How to Get There |
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245 | (6) |
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International Success at Cost Containment |
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251 | (6) |
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257 | (24) |
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Successes with Cost and Quality |
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259 | (6) |
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The Value of Electronic Health Records with Decision Support |
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265 | (5) |
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Comparative Effectiveness Research |
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270 | (3) |
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Enhancing Clinical Data as a Knowledge Utility |
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273 | (8) |
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9 Care Culture and System Redesign |
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281 | (54) |
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Community-Engaged Models of Team Care |
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283 | (4) |
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Using Production System Methods in Medical Practice: Improving Medical Costs and Outcomes |
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287 | (7) |
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Managing Variability in Healthcare Delivery |
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294 | (7) |
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Cost Savings from Managing High-Risk Patients |
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301 | (9) |
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Health Information Exchange and Care Efficiency |
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310 | (4) |
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Antitrust Policy in Health Care |
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314 | (5) |
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Reducing Service Capacity: Evidence and Policy Options |
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319 | (5) |
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Malpractice Reform and Healthcare Costs |
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324 | (11) |
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10 Transparency of Cost and Performance |
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335 | (24) |
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Transparency in the Cost of Care |
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337 | (3) |
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Transparency in Comparative Value of Treatment Options |
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340 | (4) |
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Provider Price and Quality Transparency |
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344 | (3) |
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Transparency to Improve the Value of Hospital Care |
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347 | (5) |
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352 | (7) |
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11 Payment and Payer-Based Strategies |
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359 | (48) |
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Value-Based Payments, Outcomes, and Costs |
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361 | (9) |
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Bundled and Fee-for-Episode Payments: An Example |
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370 | (6) |
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Effective Health Insurance Exchanges: An Example |
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376 | (4) |
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Value-Based Insurance Designs and Healthcare Spending |
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380 | (6) |
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Tiered-Provider Networks and Value |
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386 | (4) |
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Simplifying Administrative Complexity |
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390 | (7) |
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Technology and Simplifying Healthcare Administration |
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397 | (10) |
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12 Community-Based and Transitional Care |
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407 | (26) |
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Community Health Teams: Outcomes and Costs |
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408 | (7) |
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Palliative Care, Quality and Costs |
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415 | (5) |
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Community Prevention and Healthcare Costs |
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420 | (13) |
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13 Entrepreneurial Strategies |
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433 | (22) |
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Decentralizing Healthcare Delivery |
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435 | (3) |
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Retail Clinics and Healthcare Costs |
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438 | (5) |
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Care Coordination and Home Telehealth (CCHT) |
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443 | (12) |
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Section III The Policy Agenda |
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455 | (18) |
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Getting to High-Performance |
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456 | (9) |
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CBO Scoring: Methods and Implications |
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465 | (8) |
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15 Payments for Value Over Volume |
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473 | (20) |
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Bundled Payments: A Private Payer Perspective |
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474 | (4) |
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Medicare and Bundled Payments |
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478 | (4) |
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Bundled Payment: Physician Engagement Issues |
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482 | (7) |
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Patient Perspective and Payment Reform |
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489 | (4) |
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16 Medically Complex Patients |
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493 | (24) |
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Payment Policies and Medically Complex Patients |
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495 | (3) |
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Palliative Care, Access, Quality, and Costs |
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498 | (6) |
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Payment and Better Care of Complex Patients |
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504 | (5) |
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Care of Patients with Multiple Chronic Conditions |
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509 | (8) |
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17 Delivery System Integration |
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517 | (18) |
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Profile of System Fragmentation |
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519 | (1) |
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Payments to Promote Delivery System Integration |
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520 | (5) |
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Payment Reform to Promote Integration and Value |
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525 | (4) |
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Health Information Technology to Promote Integration |
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529 | (6) |
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18 Delivery System Efficiency |
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535 | (12) |
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Better Use of Healthcare Professionals |
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536 | (6) |
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Transparency and Informed Choice |
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542 | (5) |
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19 Administrative Simplification |
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547 | (22) |
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Administrative Simplification and Payer Harmonization |
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548 | (4) |
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Payer Harmonization on the Provider Perspective |
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552 | (4) |
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Policies Targeting Payer Harmonization |
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556 | (13) |
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20 Consumer-Directed Policies |
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569 | (16) |
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Consumer Views of Higher-Value Care |
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570 | (4) |
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Insurers, Consumers, and Higher-Value Care |
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574 | (3) |
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Policies Shaping Consumer Preferences on Value |
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577 | (8) |
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Section IV Getting to 10 Percent |
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21 Taking Stock: Numbers and Policies |
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585 | (14) |
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585 | (14) |
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22 Getting to 10 Percent: Opportunities and Requirements |
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599 | (20) |
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23 Common Themes and Next Steps |
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619 | (16) |
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A Workshop Discussion Background Paper |
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635 | (120) |
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755 | (18) |
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C Planning Committee Biographies |
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773 | (6) |
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779 | |