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Don Bradley, director of The Practical Playbook at Duke University, noted that private and governmental payers of health insurance plans consider multiple factors when deciding what benefits to cover, including consumer/employer demand for a service, cost of the benefit, evidence for effectiveness and efficiency of the service, the ability to administer the benefit consistently and fairly, presence of state or federal mandates for a service, and how the benefit will affect the marketability and adverse selection of a health plan
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