Models of potential or possible Health Care Model options are or options that are hypothetical options that members were could potentially look for in the future. The first model during this presentation, members were able to share questions ask and share questions about the models, look at the models in detail to figure out what things were appealing and then also talk amongst themselves. Really to determine what models were appealing, what questions they had and what were priorities as they select future Health Care Benefits. The proposed models, there were five selected. The first one was the current plan offering. I wont go into too much detail about that. The second model that was presented was the plan offering third party navigation and advocacy support. For this model, support is considered to be any Third Party Service provider that is not at h. S. F. That is not the members employer and not the Health Care Provider or insurer that advocates for the members and supports them throughout navigation process of health care. The third proposed plan was a consolidated plan that included kaiser as well as one other Insurance Company. And that one Insurance Company provided will provide both an hmo and ppo. The fourth model that was offered was a system competition model. That model offered kaiser as well as three other fully integrated Health Care Providers and another ppo. The fifth model was the private Exchange Model and this was described to members as the cover california model. So you have a variety of insurance providers that offer multiple and various insurance plans at different price points and Different Services. That is created to offer a little bit of flexibility and choice around offerings, as well as price point for members. One thing that i should note, kaiser was available in each of those proposed models. Ill give you a little bit of feedback from each the models, the model one was the current offerings, i so wont go into detail. Model 2 is the current plan offerings with Third Party Support. When we think about or analyze the data, one of the Key Takeaways we got from the model, was there was mixed feedback around what Third Party Support services were. When they asked question, it was really around trust. Can you trust the Third Party Support provider . What is their level of expertise in the Health Care Profession and medical needs . Are they going to this Third Party Provider held accountable to the same hipaa standards and laws in the medical field. This was about trust and wondering the fidelity of the provider. One of the key questions that came from that was how Third Party Support impact complicate the overall experience of care. So while members were fairly interested in this, they had a lot of questions about trust fidelity and the bureaucracy that might come, or the complication that might come with the Third Party Support providers. Model 3 was the consolidated plans. That provides two options. The Key Takeaways around that was how does having three options for Health Care Benefits impact choice . Is it going to minimize the way that im able to select a provider . Is it going to minimize my selection for doctors . Will i lose different options around that . And similar with coverage. If we only have three health care options, how does that impact the way that i receive coverage . And the last one was around cost. Some people thought that having only three Insurance Options would either drive up costs, because with only three, that limits the competition. And others thought because more people might be under each plan, that could drive down costs. That was a big question around costs and there were varying sides of that. The fourth model is a system competition model. This included kaiser as well as three other fully integrated Health Care Insurance providers as well as another ppo. For those of you who arent clear about what an integrated Health Care System is, it is all of the care provided under unumbrella. Theyre provider, Insurance Company, et cetera. One of the questions was how will integrated systems impact ability to receive coverage outside of network . So by integrated systems having housing all of their services inhouse, how would that impact members in seeing specialists or getting second opinions. That was a big concern. And finally, the private Exchange Model, t this model rad a number of concerns. Some of the biggest questions were around how might the plan options and choices affect equity, quality and accessibility in relation to care. A lot of the insurance providers will provide Different Services at different price points and a lot of members wondered if i select a lower price point for my Health Insurance plan will that mean that im selecting a lower quality of care. So there were a lot of questions around there. There were things that came up around all of them. Third Party Support services were offered in three of the five models. And they wondered if Third Party Support, could that be offered in all of models . And another thing that came up again as i mentioned was the level of quality and accountability that the Third Party Provider would have. As we explore different, or as members explore the different options, everyone is worried about coverage, or a lot of people questioned how their coverage is impacted once they retire as they travel or for members independence who live out of the country and out of the bay area. Im going to talk about the major themes of the asks that members had. We asked them if there were any other services they were looking for when they think of what hss provides to members. And some of these are going to be overlapping with what shenay said about the models. A key theme we heard was around Service Standards and accountability. What can hss do to extend more support for members to make sure that standards are met and make sure that patients are being served particularly around can we make sure that there are Mental Health providers available to us. Can we make sure that if the benefits say they cover alternative medicine, that the providers are there within network . And could we think about the Third Party Support . Because having support in the navigation and advocacy were something members were interested in if they believed it was going to be a high quality benefit they could trust. Members also, a lot of issues around communication. Again, support around the advocacy and problem solving, communicating in general about benefits. I know that hss does a lot of communicating, but there was still a lot of things we heard about from people, where members just werent aware that the service was available to them. So there was they were looking for better communication. And another area where they were looking for communication was around the transition to retirement. Would say in every single focus group we held, this question came up, either from people who are approaching retirement, people who recently retired, questions around what is this going to do to my benefits . How can i plan for this . What are the implications for me and my family . There were many, many questions that people had about that transition. Then the last theme that arose was meeting populationbased needs. I know that abbie mentioned we had some focus groups specific to particular populations we know have specific needs. Some of those are first responders. Some are lgbtq members or members who live outside of the bay area. And there is work to be done to engage those subgroups and really make sure that were meeting the needs of those people. I want to note that there are some things that hss is already doing around those areas. That these acs are actions are under way. One is around the Service Standards and accountability. As h. S. S. Enters the renewal period, this is an opportunity to deepen the conversations. Abbie mentioned they were having conversations about access to providers, particularly Mental Health providers. As far as enhanced communication, there is an open position for a communications director. There is a search going on and when that person is brought on board, it is hoped they can promote hss Advocacy Services that do exist and make sure members are aware of when its appropriate to call hss. We heard mitchell talking about people calling during open enrollment, but one of the things we heard in the focus group, members didnt actually think to call the Health Service system when they had issues that arose. We might hear about challenges in finding providers, but very few of them called hss for the support that could have been provided. And lastly, around meeting populationbased needs, hss is working to develop strategies to monitor and enhance services to meet the needs of these groups and that is actually something that is part of the strategic plan. I want to talk a minute about just how the things we heard and the things that hss have opportunities to take action align with the strategic goals that have been outlined in the strategic plan. One of the things that members asked for was that hss continue to negotiate really hard for affordable comprehensive and high quality care. We heard a lot of appreciation that hss was doing that work and they want to see it continue. Another of your goals is reducing complexity and fragmentation. And one way in which hss can do that is supporting that transition to retirement. And also encouraging improved communication among providers. We heard from some members who felt like there was just a breakdown in the mune indication of their communication of their network and perhaps hss could advocate for better support around that. Engage and support. We heard from members who wanted more variety and more frequent communication around the plan materials. People access different access their information in a lot of different ways, so making sure its available to them early and in a variety of formats was asked for. We heard from a number of members who asked for greater Translation Services and support. For both support for open enrollment, but in other areas as well. There are lots of languages spoken by hss members. And, again, just increasing the awareness of the services that are offered by hss would be beneficial to members. Choice in flexibility. Advocating for improved and expanded access to providers, particularly those Mental Health providers, alternative medicine and the primary care. And as far as whole Person Health and wellbeing, ensuring the Wellness Programs are accessible to all, including shift workers. We also heard a request that maybe hss had a role to play in providing members with checklist of questions they could ask of their providers, or insurers to help them be better prepared for their own advocating. And we heard a lot of positive things about eap services and members were looking to have those continued and expanded. So i just want to go over big picture summary of what we heard, our Key Takeaways. Number one, the work we did, when we do this kind of conversation with community members, sometimes you hear big surprises. That wasnt the case. What we heard really affirmed a lot of things that staff is already aware of, both the positive and the negative, which is really valuable information to have. It raises some really important questions for hss around what are the barriers to prevent members from calling hss when they could . And how can this organization strengthen communications with members about plans and benefits . How can we better support members through the transition to retirement . What are additional ways hss can hold providers and insurers accountable for excellent care . And are there targeted approaches to improving outcomes for populations with specific needs. As i mentioned in many of these challenges are already being addressed in actions taken by the organization right now. With that, were happy to take questions. President breslin any questions . Commissioner follansbee i have a couple of questions. One, its impressive and i like the summary about this enhances a lot of the themes that weve already been discussing and helps us feel tuned into what the members are. Are you happy with the sample size . Was that what was your target . And number two, i was kind of curious about the response to the urgent care issue. Because urgent care has a broad weve been dealing with this to some extent over other issues. They have a broad it has to do with availability, location, shift workers, all sorts of things. And also without integrated care model, which we support some nonintegrated, urgent care has the specter of actually not bringing communication. So im just curious to know if you have enhanced first the question about the numbers and then about the urgent care issues and if you have a sense of what members thought that meant and what they wanted. So the first question, i think we were aiming for more. And i will also say we were happy with the turnout we got. Primarily because the representation was so diverse. We looked at so many different measures for where people worked, where they lived, what their educational background, languages, race, ethnicity, all these factors and plans. And we felt like we were hearing from the spectrum of members. I think we were aiming for more like 200 and in the end we got 117 focus group participants. And then additional close to 50 who provided surveys. So we got close to our number. And as i said, i felt like the representation was good. I also felt that there was a lot of consistency in what we heard which is useful to hear. You know, the things that people were happy with, the things that people were frustrated with, and the questions they had around the models. When you start hearing repeats of the themes again and again, then you know youre hitting a lot of what you want to hit. The question around urgent care. I should mention that there is a report that were finishing that has a lot more detail on all of these aspects, so youll be able to look at that when thats complete. But i would say its interesting that you bring up that point of the connection and coordination between urgent care and other care. Because one thing that people did say was that they liked urgent care particularly when it was available in association with the hospital, so not Free Standing urgent care clinic, but the urgent care aspect of their own network, because then they knew that the information would be communicated and if there was a problem that urgent care couldnt take care of, it could be escalated to an emergency room in their network. That said, there was a lot of appreciation for the Free Standing urgent care clinics. Especially those who cant make it to a doctor during the regular office hours. I would be interested, now that weve had this foray in terms of getting feedback from the director. And weve made a larger decision to defer, going out to the market, how were going to sort of keep this fresh to align with that action. Nice queue up for my Closing Remarks on this. Thank you very much. I didnt even pay him to do it [laughter]. I want to say that the recommendations concludes our findings are in alignment with goals. While there are areas identified as opportunities for improvements, the findings reflect a positive experience interacting with Health Care Providers. These findings are really qualitative in nature and confirm that the benefit design serves members through quality, sustainability and wellbeing, core facets of the mission of hss. And we are staying abreast of the Health Care Market place in an ongoing way. As we begin this renewal process for plan year 2021, we will in parallel continue the ongoing Market Assessment to determine what the right time to advance one of the new models for the health plans and restart the procurement process. So this is kind of a moving train which we, i think, have on reflection have really its been of great value thinking deeply about what it is were trying to accomplish and getting this input from experts and members that is complimentary. So i think that will all inform us. Ive asked my team to help put together what that parallel process would look like to sort of doubleteam an annual renewal process, while we fully prepare for a new procurement process. Just because of the length of time that it will take to do the full procurement process, we will have to do it in parallel. And i believe well be able to do that this year. The market is the market. The sutter decision i think will be very informative. The rollout of the canopy product that you see is going full force. So there are some major shifts occurring in the market. Anthem is making a play in town. So there is quite a bit happening that were tuning into and paying attention that that is the rationale behind why we delayed in this last year. So it seems as though it were the right decision looking back on it. But it is something we have to look at in parallel with our responsibilities to have a solid renewal for the 21 year. I just want to thank the consultants because i think that the report shows number one