This report summarizes findings from the Urban Institute review of the subsidy policies and practices of the Massachusetts Department of Early Education and Care (EEC) in the spring of 2014. This policy review is one component of a legislatively mandated assessment of the Massachusetts subsidized child care system (hereafter referred to as the assessment). The review's goal is to help EEC more efficiently and effectively manage its provision of child care services. This review pulls together insights from interviews and focus groups with approximately 60 experts and stakeholders with a broad range of perspectives on the system. It identifies a number of important issues that, if addressed, could improve the efficiency and effectiveness of the system. Such reforms would help fill in some of the gaps in the current policy framework, which has many strong components. (author abstract)