eliminates some of the cost sha sharing resofts in higher program costs and higher premiums for all ben fishairs. while maintaining an appropriate level and quality of quarter in rural areas is a challenge, it is what we deserve. we must insure that payments made on behalf of beneficiaries and taxpayers are appropriate. this information is especially helpful as congress assesses a series of special payment adjustments which are set to exspear e expire by the end of the year. we must review policies. i'm eager to discuss the view on how to better improve care coordination on ben fieficiarien the dual population. some of the past successes may be at risk. some of this is clearly necessary but i'm concerned that the unilateral actions to address this population's needs may undermine the protections guaranteed to all medicare beneficiaries. this is a critical issue to get right the first time and i know that med pack is concerned about it as well. thank you for being with us today. i look forward to your suggestions on how we can improve medicare and i want to congratulation and thank you for accept