Shoulders working well again. So i can tell you, that in of itself qualifies me as a Health Care Consumer. And i learned many things during my experience. One was despite having the best hospitals and physicians in the world, the most advanced medical technology, the best medicines to treat most of the Health Issues we all face, the consumer must play an increased role in his or her own health care. As individual consumers of health care, we must engage in Healthy Behaviors across the course of our lives. We must engage in preventative practices, and we must be fully compliant with the care directives that come from our Physician Partners when we asked them for help and access care. So i would submit to you that transformation begins with our own behaviors. By the way tom a the word choice by the way, the word choice, consumer not patient is very deliberate. We must think age consumers in their own health all of the time, not just when they have a medical emergency or a Health Circumstances that causes them and drive them into the Health Care System. I think this is especially true when we think about how we will improve health at a time when more than half of americans live with some type of chronic condition like diabetes or obesity. A very daunting statistic and one that is getting worse rather than better. So looking through the consumer lens, how can we make it better gor . For starters, we must make health care easier to understand, all of health care. There is no question about it, we have a very complicated system. If we must assign blame, it extends across every entity involved and engaged in health care, including my own line of work. I believe insurers have failed consumers by not providing trans timely information about what things cost, quality outcomes or how the system really works, offering advice and guidance about how to navigate the system. Lots of people still think the 20 copay is the entire in total cost of their office visit. We are working on changing that. Understanding and navigating the complex Health Care System is certainly a real issue for the 8 million americans who enrolled under the Affordable Care act. Across the system of Blue Cross Blue Shield plans across the system and country, we have yielded countless questions about benefits, costs and the simple question, what do i do next . One of our individual Sales Managers in North Carolina tells a story about a community recent tatian she was making and a small town one evening during the aca in rome in time. The aca enrollment period. A few minutes into explaining the aca and coverage option on the exchange, at hand went up and asked this very direct and simple question. What is the deductible . She decided to scrap the formal presentation and just talk to folks about how the basics of health care worked and how it in terrelates to Health Insurance. We are trying harder to make things simpler and more understandable. We have done plenty in there is a lot left to work a lot of l work left to do. Many providers are now taking Customer Service into account when it comes to scheduling, billing and other administrative processes that do not necessarily have anything to do with the delivery of Clinical Care but everything to do with the experience that the consumer patient is having in the clinical setting. This kind of consumer friendly approach is long overdue in health care. It is going to continue, and we all must continue to lead it. Another thing healthcare consumers must have. They must have the resources to make the right decision about care, not just static information or pamphlets of the automobile but dynamic tools and information tailored just for you based on your unique health history. Where you live, where you can go and many other factors. There are Real Progress on this front. For example, we are rolling out the personal set of tools to connect customers for the information they need about their health. We want to get them access to everything they need to make an informed decision and have it right at their fingertips. We capture that under the concept of blue connect. This is not the way health care has traditionally worked. Think about what you do with your smart phone today that you did not do a year ago or five years ago. Interesting statistic, the Federal Reserve tells us 51 of smartphone users have used their phones for bank and 17 of mobile banking customers have made a deposit using their phones. So the question is, why not extend these kinds of on the go, readily available at your fingertip transactions to health care . There is no reason not to. Think about what could happen if you were at the playground if your children and i would dare say no one goes there with the top of mind trying to figure out the closest emergency room that you might need that day because your daughter will need care as a result of an injury at the soccer match. But if you have ready access to nearby Urgent Care Centers through a Health Care App on your smart phone, you would be repaired to make a wise decision. That decision may be to go to the urgent care, rather than going to an emergency room if it were not necessary where you would endure a long and costly visit. The differential is the access to the information and willingness to deploy. The goal of these kinds of resources is to get consumers the data they need to choose. The ones that offer the best value for the individual consumer. We are working with doctors and hospitals to develop meaningful measure and then coming up with data for them. Data leveraging incidents and should is an essential role we are playing to help make health care better. It is called only line of sight into where patients can go for all of their medical encounters. Physicians, hospitals and Drug Companies do not have all of this data. We do. Speaking of insurers, why should you as a Health Care Consumer place trust in us. It is a legitimate question. One that we get asked all of the time. Let me first say you do not have any intention, desire, need or plans or expectations to replace the medical professionals that you trust. That is not our job. To the contrary. We want to enable and equip you, the consumer, to get the highest quality of care at the most affordable price. You make the choice. Everyone wins. Everyone wins if there is a good Health Outcome at a reasonable cost. Where i see consumers accelerating the pace at a greater value is by leading the quality discussion and then fighting the right folks to the table to collaborate. In many instances the insurer has the positive relationships in a state or region to convene competing provider interest and to facilitate a collaborative conversation that yields Higher Quality at lower costs for the consumers of health care. I know that has how that is how and has worked in our state i imagine all of us can refer to the positive examples of the positive outcome from a positive collaboration. Achieving better Health Outcomes a better prices not only requires better Consumer Engagement but doctors, hospitals, pharmaceutical companies, and of course, health plans, to work together. I am actually encouraged by what i am seeing in our state. More often than not we are finding Common Ground in the first conversation. The debate about whether or not health care is going to change and be transformed is over. Does not start at that place anymore. It starts at a place about what is it that we can do together to move things forward. And how do those collaborative and out of those we are finding innovative ways to boost quality of care and address cost. In just a moment you will hear more about this from my colleague joe shui this joe swedish. Let me give you a couple of trends were seeing in North Carolina. A good place to start is with bundled payment. As many of you know, it represents a single fee for a given medical service. If the hospital and physician groups manage the care as a intended they are rewarded. If things go wrong, the insurer or medicare does not pay anything more. A Blue Cross Blue Shield of North Carolina we have bundled care arrangements with multiple practices for hip and knee replacements at five different hospitals and more are on the way. We know for example, patients are saving 1030 on the replacement surgery while the Patient Satisfaction scores out of that experience continued to go up. Your consumer is winning in that arrangement. Higher quality, lower cost, greater satisfaction. Then there are patient centered medical homes. Over three years ago Blue Cross Blue Shield of North Carolina entered into a collaborative joint venture with the university of North CarolinaHealth Care System led by a real visionary and health care. Together, beginning with a blank piece of paper, we created a model by mary care practice together called Carolina Advanced Health. It brings the entire care Team Together under one roof. Unc and blue cross are thrilled with the results so far. Two data points. Zero affordable avoidable hospital admissions, and 64 fewer Emergency Department visits then our Customer Base as a whole. That is real results. The consumer again is winning. Higher quality, lower cost and greater satisfaction. I urge you to check out Carolina Advanced Health on the web. Do you see a positive trend . What i am saying is collaboration between insurers and providers yields high quality value for consumers. I believe we can all agree zero avoidable admissions and 64 fewer trips to the emergency room is a good thing for individuals and a good and for the health care economy. Our challenge is we need to do more faster together. Now we know it is not easy to get. Doctors, hospitals and insurers to change their way. Breaking out of the mold and that rhythm is very different difficult. If it were easy, we would have artie done it in would be having a different meeting today. I am confident we will work out many of the inherent conflicts as we get deeper into the transformation of health care. The way we look at it if North Carolina is this is both our opportunity but certainly our responsibility. So we have a lot of hard work ahead of us. You will hear more in just a few minutes. After all, it took us a long time to get to where we are, so we should not fool ourselves into thinking we can sprinkle magic dust and within a couple of weeks it will be fixed. We are at the beginning of a long, revolutionary journey but we will make it other better. Let me close by borrowing a familiar quote five president kennedy. When he challenged the nation to support the effort to go to the moon, i think you will quickly recognize my edit in that famous quote. So let me begin. We choose to transform health care and do other things not because they are easy, but because they are hard. Because that goal will serve to organize and measure the best of our energies and skills. Because the challenge is one we accept. One that we are unwilling to postpone and one that we intend to win. This is our time. This is our opportunity. This is our responsibility to lead and accelerate the revolution that is health care. So let me ask all of us to come together, work together, solution together and lead together to transform our health and Health Care Delivery in our nation. I look forward to working with all of you to build a Better Future for ourselves and for future adoration generations. Thank you for the opportunity to be with you. [applause] thank you very much for those remarks. You can see why he makes a terrific chairman. Now i will take a moment and say for those people standing in the back there are very few but a few seats up front and i would invite anybody at this time who wants to make their way up and find a seat. Now it is my pleasure to introduce joe swedish, ceo of wellpoint soontobe anthem, the nations leading Health Care Benefits providers serving 37 million americans or one in nine. As ceo, he has overseen the launch of more than 1000 new tron x on Health Insurance exchanges across 14 states. And lead the development of the nations largest portfolio of valuebased contracts. With as many years and experience in health care, including 24 as ceo for major health and Hospital Systems, joe has a unique perspective combining that of an insurer with that as someone who has really run some of the best Delivery Systems in the country and he is relieved leading the transformation of health care. Joe . [applause] good afternoon. Thank you for those generous comments. It is truly great to be with you today and speaking with some really honored panelists who represent the best and brightest in terms of perspective about where our society is factoring towards with respect to Health Reform and what outlook tells us, and quite frankly, we are making some very serious bets looking at the future and executing on initiatives that we believe will make a tremendous difference in the lives of so many people in the United States. Based on, and i will go back to what maryland said, and i think it will be amazing a lot of the common language developing by the way of the panelists and what maryland communicated earlier, the issue we are struggling with in terms of affordability, cost, and access. As someone that has lived through many decades of Health Care Provisions across the country, i can tell you that we have some very serious fundamental problems in how care is delivered across those three elements that are fundamental to help judge whether we will be successful in the journey or not. It is fascinating in many ways right now because all of us together, brad did a remarkable job in terms of providing inspirational outlook in terms of what is possible. I want to reiterate the point that he made. We are part of evolutionary process of revolutionary process in terms of Health Care Reform developing and what we will be able to achieve in the years ahead. What we have witnessed is we are developing a common language in the industry no matter what sector you are in. I think those that are truly dedicated to the reform necessary are equally committed to affordability, access and the advancement of quality and safety in terms of how care is delivered. What i observed after being in my access for 30 years the moment we have arrived at today is we are witnessing the convergence of health, health care, policy financing, care delivery, government consumers of the private sector in the one Massive Initiative to move the industry forward. Indeed the challenges and complexities are daunting and exhilarating simultaneously. And what i believe that is happening at this moment is we are advancing beyond the work i was involved in and many of you have been equally involved in. I call it slogging through decades of the disconnected system in many ways that has created an many ways poor access, high cost, and therefore on affordability and finally, questionable quality and safety. With that backdrop, let me share thoughts with you about where i believe we are going as a delivery system. As nancy mentioned, i spent the bulk of my career eating integrated systems. I just moved to wellpoint a couple of months ago to take on a whole new challenge. The reason i did it is i believe there is a convergence where providers and payers are working together in partnership to change the game as we have known it for so many decades. It is the duality of perspective i would like to share with you today that i think has informed my view of not only what is coming in the years ahead but also, what we should see. Just because we believe it will be coming does not mean it is the right initiative. We need to seek new initiatives based on two fundamental characteristics. Innovation and collaboration. I will keep coming back to those two elements as themes in my remarks. So first, what i would like to do is beat to the trends, the trends that are driving the revolution in Health Care Reform. I would also like to highlight wellpoint. I will be coming back to wellpoint repeatedly because i want to give you a sense of what israel. What is happening in the many markets that we as a Payer Community or Provider Community are providing to our nation. Let me context. First, wellpoint, we serve 37 million members in our health plan. One in nine americans. In addition, this overlays on the fact that we are is the leading provider of serving an official risk space, as well as in the Government Services space. We have 4. 8 million medicaid beneficiaries part of the plan. We serve 19 states related to Medicare Programs. 14 states related to our blue portfol