Nearly everyone agrees that the nation's health care system needs to be reformed. Nearly a dozen major reform plans have been debated in Congress. But beyond the political challenge of passing a reform package lies an even bigger challenge - how to make health reform work. This challenge will persist well beyond the 1990s.

Long after the debates over competing national health plans have faded, the states will be faced with the supremely difficult task of reforming their health care finance and delivery systems and translating both new and existing federal health policies into effective administrative action.

The nation's health care finance and delivery systems are already immensely complex and problem-ridden. Is it possible to achieve meaningful reforms without adopting new administrative strategies and structures that are equally complex? What role do the states now play in administering the nation's health care system? Is it possible to design administrative success into national health reform plans from the start?

Produced in close consultation with state health care officials from all around the country, this important volume offers practical and timely recommendations for how to make health reform work. It addresses the central implementation, management, and federalism dimensions of reform.

Chapters by some of the country's leading health policy and public management experts explore the administrative challenges of reform as they relate to health alliances, cost containment, quality of care, medical education and training, and other key issues. They discuss various working principles for developing an administratively sound health reform policy.