mendoza-mcdonnell for working together ms. moran and her team to do a lot of the work to make sure that we are earning a lot of support from our community and business partners i'd like to questions or comments i'm sorry no public comment cards. >> ms. wynns and . >> i want to thank you for this and all the work you've done i want to point out to everybody this is something that is - we're not only we but everyone is invent now ways to support the public agencies and you know we've had some fits and starts i know but i think everybody has i think we're way ahead and all the foundation work we've done all the discussions the fact we'll have clearly articulated in our vision what we mean by working with private partners all of that is for the good so i'm very supportive i think that is a great idea the next thing to work with the private board of this entity which is really private mechanism that is part of the psychopath and i'll have to disagree is it not unfortunate we're on public agency that is a good thing but the necessities th

moran? >> chairwoman, thank you very much. ms. gilligan, the faa's 2004 sport pilot rule allows private pilots to fly small aircraft without a third class medical certificate under certain safety restrictions. the issue i want to explore is altitude. is there a clearly defined safety benefit for one altitude over another? i think theory is that pilots maybe can fly lower than the 18,000 feet, the floor for class a airspace. what should we know about safety based upon the ability to fly at various altitude levels? >> well, senator, i think there are a couple elements to that. i'm sure mr. baker can expand upon it as well. the one you point out is that the structure within the airspace tends to separate aircraft based on the sort of technical abilities of the aircraft. lower airspace is not as conducive to jet operation, for example, or to commercial operations. higher altitudes allow them to be more efficient. so there are some elements of the airspace design that suggest separation of operations by altitude. >> my question is, can

moran. senator murray? >> thank you very much mr. chairman. thank you very much to all of our panelists. i really appreciate all of you participating today. ms. peterson, i'm really excited to hear about the delivery system reform work under way. and i'm proud that our hospitals have been recognized as national leaders in increasing the quality and safety of care. i'm particularly excited about the recent grant from the centers for medicare and medicaid innovation you mentioned in your testimony to support the healthy washington initiative efforts to improve care statewide that will reduce costs and stabilize some of our rural hospitals. what have you found to be the most significant barriers to integrating care in the first year of this effort? >> at this point and you're right, it is very exciting what is going on in the state of washington, i would go back to that fragmented reimbursement system. not only are the incentives different based on what line of service you're providing, but as my colleague mentioned about the racs and the amount of time it takes to reimburse some of these systems, it's years out before we know what our true fin

moran. senator murray? >> thank you very much, mr. chairman. thank you to all of our panelists. i really appreciate all of you participating today. ms. peterson, i'm really excited to hear about the delivery system reform work under way in washington state. and i'm really proud that our hospitals have been recognized as national leaders in increasing the quality and safety of care. i'm particularly excited about the recent grant from the centers for medicare and medicaid innovation you mentioned in your testimony to support the healthy washington initiative, efforts to improve care statewide that will reduce costs and stabilize some of our rural hospitals. what have you found to be the most significant barriers to integrating care in the first year of this effort? >> at this point, and you're right, it is very exciting what is going on in the state of washington, i would go back to that fragmented reimbursement system. not only are the incentives different based on what line of service you're providing, but as my colleague mentioned about the racs and the amount of time it takes to reimburse some of these systems, it's years out befo