Is the Wait Over for California Patients?

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Is the Wait Over for California Patients?

And how with this affect nurses?

By Elizabeth Hanink, RN, BSN, PHN
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Ever realize that you or a patient needs to see a specialist and be stunned to discover that, no matter the urgency, the wait for an appointment can be several weeks? You are not alone. Over the past four years, wait times increased by 8.6 days, and times in Los Angeles are among the worst nationwide at 24.2 days. But that is about to change, at least here in California.

Under new state regulations taking effect this fall, appointments for non-urgent primary care need to be available within 10 business days; for a specialist, the wait cannot exceed 15 days. Urgent appointments must occur within two days, and an after-hours emergency call to a physician must receive a call back within 10 minutes.

These new rules apply only to patients in managed care, but there is widespread expectation that many private practice physicians and insurers will adapt the same model. Although the guidelines represent more than seven years of contentious negotiation among insurance companies, providers and consumer groups, several details remain unresolved. All stakeholders want to avoid red tape and increased costs.

Hiring more doctors and contracting with additional hospitals will be a first step. Providers will also need to limit patients to a number they can reasonably handle, and many will need to make their offices more efficient.

What is the impact on nurses? According to Cindy Ehnes of the California Department of Managed Health Care, independent nurse practitioners who contract with managed care will need to conform. Only indirectly? Better ask yourself: Who manages most physician offices? Who provides patient advocacy within the health care system? Who provides case management?

Elizabeth Hanink, RN, BSN, PHN, is a freelance writer with extensive hospital and community-based nursing experience.

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