OHS’s response to our offer to work together to improve the health of every Connecticut resident is very welcome. In that spirit, the letter clarifies a few misunderstandings of the advocates’ concerns, highlights concerns from the advocates’ letter that weren’t addressed, and differs with some of OHS’s points. The newest letter notes that, while primary care capitation is voluntary for providers and health systems, it is not voluntary for patients. The advocates’ letter neither endorsed nor rejected the fee-for-service payment model. We called for a robust monitoring system to ensure that resources are devoted to improving care for people. We urged OHS to invest in improvements to care over increasing primary care physician incomes.