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... One objective of this report is to encourage realistic expectations about this potential by building a broader understanding of the difficult but important steps needed to move toward the goals for practice guidelines stated in P.L 101-239, or, as it is also called, the Omnibus Budget Reconciliation Act of 1989 (OBRA 89~. CONTEXT The committee began its work with an understanding that the legislation establishing AHCPR is one consequence of accumulated public and private frustrations about the perceived health and economic consequences of inappropriate medical care.


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