Yesterday twenty independent consumers, advocates and providers sent a letter to the Lieutenant Governor expressing our grave concerns about the “current plans for widespread precipitous changes” in Medicaid’s payment model. The letter outlines concerns about re-imposing financial risk, this time on providers of care, that creates incentives to deny needed care. States with far more experience than ours in successful reform are struggling to make this work. At the least, taking time for thoughtful policymaking and consensus building, is essential to avoid unraveling the hard won success. We remain “fully committed to building value in our system and linking incentives to quality care while protecting consumers.” And we remain committed to working collaboratively toward those shared goals.