is raymond tsai, md ms, vice president, advanced primary care, purchaser business group on health (pbghician and also group benefits society so i'll shout out again there (laughter). >> but the um, i - um, what was i going to say sorry i represent prejudice group on health and primary care we're a nonprofit alcoholic about 40 jump about purchases and we work together to advance access, affordability and equity in the healthcare system i can't imagine one of the main ways we're doing that to increase the investment think primary care but we don't want to just do that and absent quality checks what we developed in conjunction with the members is the um, care excellence program was developed in conjunction with the members to look at what are the standards and what we want from the primary care system to be sure we are putting departments to where we know are high quality and get the outcomes we want and we have to do this work because the primary care system is in duress and afternoon a wait time for a primary care appointment this is a pinpoint that is by in-home supportive services memb