21 Fall/Winter 2019 continues be ready for extreme cuts in your payment. Medicare and Medicaid are on the path toward value-based payment, and they’re not hitting the brakes. They are hitting the gas. Having been a health care policy wonk since the early 90s, I believe more than ever that it’s in the best interest of patients, providers, and payers to work together to align incentives to keep Oregonians healthy and keep costs in check. That spirit of collaboration is what you witnessed in Sunriver. I had sponsors who go to association meetings in many different states come up afterward and say, I could never have imagined seeing a hospital leader sit with an insurance partner and talk about what a great relationship it is. They were blown away. I rest my case, Oregon’s a very special place! What else would you point to with pride and say that hospitals made a contribution? I’d point to two areas. I have been fortunate to work for a membership that believes in their heart of hearts in doing the right thing. And when I look back at what we’ve done around I am confident that he members of this organization want to be proactive. They have demonstrated the desire to help shape what value- based payments models look like, but it’s going to take perseverance and flexibility.