Pat Fry, president and CEO of Sacramento, Calif.-based Sutter Health since 2005, has a front-row seat to one of the most interesting healthcare environments in the country, as California is home to many health systems and insurers rapidly implementing value-based care.
Mr. Fry took some time to share his thoughts about the pace of change in California, the most interesting changes he sees today and the common attributes that make health systems function best. 
Question: Is there still a big difference in the pace of change in healthcare delivery in California versus the rest of the country?
Pat Fry: The pace of change in California is moving at a good clip. My observations and conversations with other leaders suggest a fairly rapid move toward population health management. This requires systems to have a suitable infrastructure to successfully manage a population, and we're seeing a significant focus on building ambulatory networks, care coordination systems and post-acute (SNF, acute rehab, home health, etc.) strategies.
Q: How quickly is the pace of change occurring? How much is staying the same in terms of the core delivery of care and the business of running a system?
PF: There is much more focus on ambulatory services today than I have seen over the course of my career. Also, there is broad recognition and acceptance that the historical fee-for-service payment model is not sustainable. Accordingly, there is much more focus on building networks of care and changing the historical relationship between providers and payers.
Q: On a system level, at Sutter Health, what are the most interesting changes or efforts you see today?
PF: Around our Sutter Health network, there is tremendous focus on ensuring a personalized patient experience and on the external market. We understand our patients want to interact with our system in a new and different way. They want to make appointments online, have access to physicians after hours and on weekends, and be able to access their medical information 24/7. We are spending a great deal of time better understanding how we need to deliver care in a way that creates a truly unique experience.
Q: Is there an ideal health system size today? How does one assess this?
PF: While I don't believe there is an "ideal" health system, all great systems share multiple common attributes. They commit to providing care in an integrated manner, to physician leadership at all levels of the organization, to delivering services the way patients want and expect it, and to focusing on the "whole" individual's needs. This means partnering with patients and families before they actually need care.