Our Vision By 2040, we can create a new health system that will help individuals, families, and neighborhoods thrive. It will be a system that fosters healthier, more resilient people and places. It will provide us with high-quality care when and where we need it, and it will value investment in our health and in our communities. No longer will we talk about what is wrong with our system; instead, we will rejoice in what we have achieved together and we will look forward to what else is possible. Americans will be healthier. We will live longer, more productive lives. Our rates of chronic disease, such as asthma and diabetes, will be lower. Our focus will have shifted toward things that support health, like good nutrition, physical activity, quality housing, better jobs, and neighborhood engagement. Our health status will no longer be predicated on where we live. Our communities — including our homes, schools, workplaces, and neighborhoods — will be healthier too. Our policymakers will consider potential effects on people’s health when making decisions about zoning, housing, new buildings, roads, public transportation, parks and playgrounds. Our doctors, nurses, and other healthcare providers will work in teams and mostly in community-based settings, providing coordinated primary care and prevention. Many of our hospitals will be smaller and patients will turn to expensive emergency rooms only for true emergencies. Our regional health systems will function more efficiently, focusing on assessing and meeting the needs of their local communities. And America will be a healthier nation. Our transformed regional health systems will be contributing to stronger local, state, and national economies. Our healthcare costs will be under control and our workers will be more productive. Our providers will be paid in ways that encourage higher quality and better health outcomes. And, increased efficiency will allow us to reap savings that can be freed up to invest more broadly to create healthier communities. The way forward starts with local and regional health systems and the communities they serve. Currently, we have a series of fragmented, localized health systems where investments, practice patterns, and health outcomes vary from region to region. These systems have evolved over time in response to myriad local, regional, and national conditions, but their primary imperative has always been the same: to serve their local communities. And that imperative has not changed. If anything, it has grown more urgent. At issue is not scarcity of dollars, but lack of an aligned vision, a system-wide strategy, and a long-term plan. By thinking differently and working together to use our medical care and community assets more wisely and with an eye toward the future, we can make this vision a reality.