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Under the Affordable Care Act, the health insurance marketplaces can encourage improvements in health care quality by: allowing consumers to compare plans based on quality and value, setting common quality improvement requirements for qualified health plans, and collecting quality and cost data to inform improvements. This issue brief reviews actions taken by state-based marketplaces to improve health care quality in three areas: 1) using selective contracting to drive quality and delivery system reforms; 2) informing consumers about plan quality; and 3) collecting data to inform quality improvement. Thirteen state-based marketplaces took action to promote quality improvement and delivery system reforms through their marketplaces in 2014. Although technical and operational challenges remain, marketplaces have the potential to drive systemwide changes in health care delivery.

The Affordable Care Act seeks to help small employers offer coverage by reforming the small-group market and establishing Small Business Health Options Program (SHOP) marketplaces. Seventeen states and the District of Columbia chose to operate their own SHOP marketplaces in 2014, with the federal government operating the SHOP marketplace in 33 states. This brief examines state decisions to enhance the value of SHOP marketplaces for small employers and finds that most have set predictable participation and eligibility requirements and will offer a competitive choice of insurers and plans. States also are seeking to facilitate small employers' shopping experience through online tools and access to personalized assistance. While not all SHOP marketplaces are yet functioning as intended, their establishment offers an opportunity to identify successful strategies for improving the affordability and accessibility of coverage for small employers.

Characterized by originality and proprietorship, the modern paradigm of authorship developed in the British long eighteenth century alongside philosophical upheavals in concepts of identity and an increasingly free-for-all literary marketplace in which the author was commodified along with his or her works. Literary historians have associated the “author-function” with the logic of copyright law, introduced in 1710, but the ideology of original authorship also developed as a defense against the more chaotic practical reality of the circulation and ownership of texts. In Scandalous Figures I demonstrate how Eliza Haywood, Laurence Sterne, Charlotte Smith, and Lord Byron resisted this defensive formation by acknowledging the fluidity of modern identity, incorporating it into their self-representations, and paradoxically transforming it into a practice of the self. Each of these authors capitalized on the intersection between authorial identity and several areas of cultural fascination: sensibility, the philosophy of personal identity, fictionality, theatricality, and the evolution of a reading public. Especially important was their awareness that scandal blurs the boundaries between categories that were sites of intense cultural energy, in Byron's time as in Haywood's: fact and fiction, private and public, life-writing or history and literature. Rather than pin their authorial names to an essential self, these authors ironically accept the way a name circulates through imaginations, economies, and significations. The striking similarity in their self-performances, across periods and genres, indicates the persistence of an alternative genealogy alongside the development of the mythic status and “fictional identity” of the original, proprietary author. If the formation of the unitary Romantic subject was the result of one strategy to navigate the shifting terrain of identity categories, then the performance of a fictional, scandalized subject was another. For Haywood, w

Characterized by originality and proprietorship, the modern paradigm of authorship developed in the British long eighteenth century alongside philosophical upheavals in concepts of identity and an increasingly free-for-all literary marketplace in which the author was commodified along with his or her works. Literary historians have associated the “author-function” with the logic of copyright law, introduced in 1710, but the ideology of original authorship also developed as a defense against the more chaotic practical reality of the circulation and ownership of texts. In Scandalous Figures I demonstrate how Eliza Haywood, Laurence Sterne, Charlotte Smith, and Lord Byron resisted this defensive formation by acknowledging the fluidity of modern identity, incorporating it into their self-representations, and paradoxically transforming it into a practice of the self. Each of these authors capitalized on the intersection between authorial identity and several areas of cultural fascination: sensibility, the philosophy of personal identity, fictionality, theatricality, and the evolution of a reading public. Especially important was their awareness that scandal blurs the boundaries between categories that were sites of intense cultural energy, in Byron's time as in Haywood's: fact and fiction, private and public, life-writing or history and literature. Rather than pin their authorial names to an essential self, these authors ironically accept the way a name circulates through imaginations, economies, and significations. The striking similarity in their self-performances, across periods and genres, indicates the persistence of an alternative genealogy alongside the development of the mythic status and “fictional identity” of the original, proprietary author. If the formation of the unitary Romantic subject was the result of one strategy to navigate the shifting terrain of identity categories, then the performance of a fictional, scandalized subject was another. For Haywood, w

Characterized by originality and proprietorship, the modern paradigm of authorship developed in the British long eighteenth century alongside philosophical upheavals in concepts of identity and an increasingly free-for-all literary marketplace in which the author was commodified along with his or her works. Literary historians have associated the “author-function” with the logic of copyright law, introduced in 1710, but the ideology of original authorship also developed as a defense against the more chaotic practical reality of the circulation and ownership of texts. In Scandalous Figures I demonstrate how Eliza Haywood, Laurence Sterne, Charlotte Smith, and Lord Byron resisted this defensive formation by acknowledging the fluidity of modern identity, incorporating it into their self-representations, and paradoxically transforming it into a practice of the self. Each of these authors capitalized on the intersection between authorial identity and several areas of cultural fascination: sensibility, the philosophy of personal identity, fictionality, theatricality, and the evolution of a reading public. Especially important was their awareness that scandal blurs the boundaries between categories that were sites of intense cultural energy, in Byron's time as in Haywood's: fact and fiction, private and public, life-writing or history and literature. Rather than pin their authorial names to an essential self, these authors ironically accept the way a name circulates through imaginations, economies, and significations. The striking similarity in their self-performances, across periods and genres, indicates the persistence of an alternative genealogy alongside the development of the mythic status and “fictional identity” of the original, proprietary author. If the formation of the unitary Romantic subject was the result of one strategy to navigate the shifting terrain of identity categories, then the performance of a fictional, scandalized subject was another. For Haywood, w

[4], 40 p., Item incorrectly attributed to Thomas Ash in Wing. Entry for A3934 cancelled in Wing (2nd ed.)., Reproduction of original in Huntington Library., (DLPS) A25996.0001.001, (stc) Wing A3934aA, http://quod.lib.umich.edu/t/text/accesspolicy.html, This text has been selected for inclusion in the EEBO-TCP: Navigations collection, funded by the National Endowment for the Humanities. To the extent possible under law, the Text Creation Partnership has waived all copyright and related or neighboring rights to this keyboarded and encoded edition of the work described above, according to the terms of the CC0 1.0 Public Domain Dedication ( http://creativecommons.org/publicdomain/zero/1.0/). This waiver does not extend to any page images or other supplementary files associated with this work, which may be protected by copyright or other license restrictions. Please go to http://www.textcreationpartnership.org/ for more information.

[4], 40 p., Item incorrectly attributed to Thomas Ash in Wing. Entry for A3934 cancelled in Wing (2nd ed.)., Reproduction of original in Huntington Library., (DLPS) A25996.0001.001, (stc) Wing A3934aA, http://quod.lib.umich.edu/t/text/accesspolicy.html, This text has been selected for inclusion in the EEBO-TCP: Navigations collection, funded by the National Endowment for the Humanities. To the extent possible under law, the Text Creation Partnership has waived all copyright and related or neighboring rights to this keyboarded and encoded edition of the work described above, according to the terms of the CC0 1.0 Public Domain Dedication ( http://creativecommons.org/publicdomain/zero/1.0/). This waiver does not extend to any page images or other supplementary files associated with this work, which may be protected by copyright or other license restrictions. Please go to http://www.textcreationpartnership.org/ for more information.