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Directory Results for Implementing National Health Re in California Payment and Delivery System Chanages California cannot rely on the ACAs patchwork alone to resolve cost and quality problems in the states health care system Inefficiencies must be addressed to Implementing National Health Re in California: Payment and Delivery System Chanages. California cannot rely on the ACA s patchwork alone to resolve cost and quality problems in the state s health care system. Inefficiencies must be