Carmela Castellano-Garcia, president and CEO of the California Primary Care Association, offers her insight into the challenges facing the California health care industry, and the changes to come. For more from Castellano-Garcia, check out “Wonder Women” in our March issue. Sign up for our newsletter and we’ll email you when it’s available online.

What’s been the biggest change in the California nonprofit health industry over the past year?

I think the biggest change in our sector has been the overall uncertainty at the federal level, and the anxiety it has created in our state. The current political environment has had a tremendous impact on the health care landscape. While not state-specific, the constant and ongoing threats to the reforms put in place as part of the Affordable Care Act have created a huge challenge for us in the past year. Additionally, potential federal funding cuts, regulatory landscape changes and alterations to our immigration policies have all had an impact as well. We have also noticed increased competition for financial resources, workforce and market share. While the nonprofit health sector greatly benefited from ACA and Medicaid expansion, there is a heightened sense of protection to keep these programs intact.

What do you foresee as the biggest change on the horizon in the year to come?

The biggest change on the horizon for community health centers is an influx of new players in the health care marketplace. While the Affordable Care Act increased competition among mainly already existing providers, there are new players on the horizon that will dramatically change the health care system overall: Non-health sector entities like Amazon, Apple, Berkshire Hathaway and JPMorgan Chase entering the healthcare marketplace, and retail chains like Walmart and Target venturing outside of pharmaceuticals to provide health care services … will create a huge amount of change for all providers within the health care sector. We also need to keep an eye out for rapid, technological advancements and their implications for health care.

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