The healthcare delivery system in the United States is under unsustainable stress. How can individual hospitals, health systems, and health plans adapt to current changes and prepare themselves for bigger shifts ahead? This broad topic was the subject of an extraordinary gathering in January 2015 of healthcare executives representing leading organizations from around the country. In a series of conversations moderated by HealthLeaders Media editors, these experienced leaders shared their organizations' strategies, opened up about their anxieties for the future, and offered a range of perspectives that may be brought to bear on the big issues facing healthcare.