Medicaid expansion and value-based payment reform are driving rapid change in North Carolina’s health care landscape. Health care systems and communities are asked to re-design care to achieve equity, access, and value in this evolving marketplace within the context of growing patient demand, staff shortages, and rapid technologic innovation. Primary care has never been more important as health systems move beyond reactive “sickcare” to proactive support of health and wellness. Through the Primary Care Transformation and Health Equity in the Era of NC Medicaid Expansion Conference, you will have the opportunity to engage with policy makers, innovators, community members, and clinicians to explore the opportunities and challenges of this moment in North Carolina. We hope that the conference will spur innovation and encourage attendees to reflect on the transformative power of community partnership and engagement to address the structural inequities in health.