NEJM Perspective Outlines Reform Law Hurdles in Calif.
"The stakes for Californians and their physicians are enormous" under the policy changes that will take effect under the federal health reform law, Andrew Bindman of UC-San Francisco and Andreas Schneider of the George Washington University School of Public Health write in a New England Journal of Medicine perspective. They discuss how California is working to roll out the reform law by "pursuing three main implementation strategies": expanding "coverage to the uninsured before 2014 on a county-by-county basis"; using the five-year, $8 billion Medi-Cal waiver to support safety-net hospitals; and expanding enrollment in Medi-Cal managed care programs. Medi-Cal is California's Medicaid program. However, the authors caution that the state faces numerous obstacles, such as "daunting budget challenges" and low rates "of physician participation in Medicaid."
- "Catching a Wave -- Implementing Health Care Reform in California" (Bindman/Schneider, New England Journal of Medicine, 3/30).