we're going to hear some framing remarks first from larry casalino, and i'm going to introduce him briefly as with all these participants. larry is the division of outcomes and effectiveness research and the livingston farrand professor of public health in the department of public health at weill cornell medical college that he came to cornell after nine years at the university of chicago where he was a tenured associate professor. previously he worked for 20 years as a family physician in private practice in california. is also worked extensively with the federal trade commission and physician groups and hospitals on antitrust issues. related to the clinical integration of physicians and of a physician hospital organization. we're delighted, will thereafter that from kavitta patel is a board certified in internal medicine physician working to shape the future of our health care system and who recently stepped down as the director of policy for the obama white house office of public engagement and intergovernmental affairs. before that she served as a deputy staff director for the senate h

larry casalino start a slide is a key point. we share one thing which is we've given more talks in university of chicago for anyone else. you never get past the first slide there. so the whole talk on the first light at the university of chicago, you guys seem to let us proceed. i don't know. i don't know what to do with that. larry, you worked out well and i will follow your example. what i was going to say before you interpt, was payment incentives are going to shape the prevalence of the model by which my providers, the pairs and the attractiveness of patients. it's going to affect the evolution of the market medical homes take off, what they look like in five years is going to really matter how we pay for them this year and next and the year after. going to affect was on those teams, what the tabs are and how they are rewarded. so i feel like the incentive matter in time, it's not just all by the way, we need to see how to pay for it. when i say pay for i don't mean finance a. i mean write a check to somebody today. for some

had to, and we're in the middle of, a cultural transformation that i think will link back to larry casalino's remarks that start offered a we talk about what we really need to redesign and change work and change your perspective. in our case that redesign involved harnessing new technologies, and again the theme of this meeting, making more efficient use of our teams, people, and rethinking what medical care was all about. a little bit of background. group health is been around for 63 years. we are consumer governed, called the clock. we are based in seattle. we have 620,000 members. we are growing. we have 26 primary care centers, sixpence the units and one tiny hospital. 960 physicians, and we contract with a large network of over 9000 physicians and 39 hospitals. i am director of the research institute which is an house, but public oriented, not for profit, public sector research group. and it was the place with a chronic care model developed. and you would think that group health would have no problem with primary care, i'd in fact we have our own strides. one of those of today's meeting