In summation, Luke's article presents a series of concepts and tools that provide insight into local system building. Most of the material holds up well to the "reality test." Additional studies should be undertaken that include ambulatory, aging, and social services. The regional system of the future will likely include a range of services from wellness to hospice. We need to know how to bundle such services and provide them within the capitation payments. Such service offerings must be easily accessible to the consumer. We have our work cut out for us!