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Its dealing with the uncertainty of all the contracting, exactly how much am I going to get paid, and am I going to have to provide a discount [to the insurance company] for some parts and not others, and how much is it going to be that can take a really long time, especially when the insurers are contracting on a per-person basis, said Rena Conti, a professor at Boston Universitys business school, who is studying different ways of paying for expensive therapies like CAR-T