i don't know if that -- >> commissioner follansbee: it does. just to point out that your list of manage the health care, misses -- i can see when the last hemoglobin was, but i can't see if i have one on order. and when that was due. and so that's what i'm trying to sort of bring in. that in order to get the results that you want, and want the member to be kind of in charge or his or her caretaker or spouse or whatever. it would be nice if there was a little more enhancement in that regard. that's the only thing. >> that is good feedback and it is constantly being enhanced and changing. >> absolutely, hopefully this will help to continue the discussion. i know there is still follow-up. and we're happy to talk about complex care management as long as we need to. so director, we can follow up and see what other discussions we have, but i'm glad the doctor could come and share some of the information. >> any other questions? >> thank you. >> thank you very much. >> president breslin: is there any public comment on this item? >> richard again, reti

. >> commissioner follansbee: part of the problem i have, obviously, i was a physician for many years, but for members, patients, these medical groups are somewhat transparent. there is hill and this and that and there are all kinds of things, so people get very confused and may not fully appreciate. i guess the question is, can you assure us we won't be getting phone calls from the 49 who show up and is there a mechanism to deal with that? >> so the member should have a name on their membership card with an address to where to go. >> commissioner follansbee: right. >> that would be their primary care doctor. if they don't go to that location, the sutter foundation employee at the front desk -- and we're not sutter -- should be running eligibility and explaining to them, because they don't control those, i can't assure they're going to be able to say the right thing at the right time, but the card should indicate where they need to go. best practice, when they make an appointment, that front desk should call and say you're no longer assigned to us, so they should be able to mitigate i

>> commissioner follansbee: i have a couple of questions. one, it's impressive and i like the summary about this enhances a lot of the themes that we've already been discussing and helps us feel tuned into what the members are. are you happy with the sample size? was that -- what was your target? and number two, i was kind of curious about the response to the urgent care issue. because urgent care has a broad -- we've been dealing with this to some extent over other issues. they have a broad -- it has to do with availability, location, shift workers, all sorts of things. and also without integrated care model, which we support some nonintegrated, urgent care has the specter of actually not bringing communication. so i'm just curious to know if you have enhanced -- first the question about the numbers and then about the urgent care issues and if you have a sense of what members thought that meant and what they wanted. >> so the first question, i think we were aiming for more. and i will also say we were happy with the turnout we got. primaril

>> one medical. >> they do. >> commissioner follansbee: they do? they are? >> yeah, they kind of -- i don't know for certain who all they're connected with but i think it's pretty much everybody. >> commissioner follansbee: maybe we do have them back, because the member who is a hill physician patient is seen there, is the lab and the encounter automatically transferred to some medical record? so there is continuity of care that we heard the members want? there are pieces about all of this that i still am a little bit confused. i can understand the ease of making an appointment online if you're getting your physician care at one medical, because they're all over the city and i assume outside the city limits, but i don't know. again, these are issues that we would need -- would want to know in terms of how to direct members in terms of -- what members want and need. this is not really a substitute if it doesn't meet certain criteria. >> they came on the market 15 years ago? and they've been around a while and they were cutting edge when they came on market wi

. >> commissioner follansbee: i guess i still hear a gap. and i think that we would be interested in hearing how that gap is being looked at. in terms of, i know as a specialist in the hospital, i would often say to the hospital and the house staff team, have you called the primary doctor? do they know the patient is here and what is happening to them? a small fraction of them, i would bet, 5% of them make rounds in the hospital, on their own time to see their patients during hospitalization, by may be brief of longer. i understand the model, butt system -- but the system doesn't really encourage that and all of a sudden, the primary sort of gets handed a patient on discharge and sometimes the hospitals, they institute a program where the hospital called the patient a week later to see how they're doing, but after that, the hospital was out of the picture. assumption was the primary care, but they have, as in every health care system, not just kaiser, they have their hands fall just dealing with walk-ins that don't have insurance that day [l

>> commissioner follansbee: can you go back to page 4, the blue shield trio flex funded. you said there was during this period, $12 million decrease in fund balance due to unfavorable claim experience, what kind of claims are those, do you have any idea? >> so in trio, let me make sure i have the right report. we're talking about through september? >> yes. >> yes. so in the last three months, we've seen a peak in high cost claims. those are claims over a million dollars. what happens with trio is that the -- correct me if i'm wrong, mike -- but in trio, the risk on the claims is born by blue shield. so while this is alarming, there -- it still doesn't present a really super -- i believe that at the end of the year, this will wash out. but we are -- we have a meeting with blue shield tomorrow. we're planning to ask questions. we're seeing their utilization where mike has been in contact along with me with aon. with the account management team for blue shield. and we're really monitoring this carefully. >> all right. >> mike clark, aon. when we started to see the uptick in

follansbee would allow me, for people to mutate. secondly, treatments have changed.we now have immunotherapy, general treatments that target these cancers. we now have new models of care and you'll see as we go through the place of service therapy, how it's occurring now in the patient setting or even in the patient's home. and lastly, we are improving. one of the things that you'll see as we go through this is the stage of the disease when it is identified or being treated for, has gone down. so instead of being stage four, when it's widely metastasized, they're catching it earlier than stage four or earlier in treatment. i would mention that in 1975, your survival for prostate cancer was 68%. in 2012, your survival rate has moved up to almost 99%, and that's just because of education and treatment opportunities that are available. >> can i ask a question about that. >> sure. >> when you say survival, is it five-year survival, three-year survival, ten-year survival? >> five. >> so when somebody has lymphoma, and they're getting some scans on an annual basis, do thos