Happy new year! I hope your holidays were spent with the people you love most. I also hope they were restful because, frankly, trustees have a lot to do in 2013. Fortunately, this issue is filled with guidance for the year ahead.

First, delivery system transformation can't just continue — it must accelerate. In our cover story, we talk to rural hospitals that are working toward accountable care organizations. Their experiences have value for all hospitals, regardless of size. And in our annual trends piece from Steven T. Valentine, he says that the hospital field has no time to lose: Medicare and Medicaid cuts, along with lower reimbursement from commercial plans, will force hospitals to find better, cheaper ways to provide care, often outside their four walls.

Strengthening the bond with physicians goes hand in hand with system transformation. Medical homes, ACOs, home monitoring and the electronic health records to support them must have medical staff buy-in. William Jessee, M.D., of Integrated Healthcare Strategies, says that successful relationships with physicians depend on enhancing "their feeling that they get as much from their association with your institution as they give in terms of the volume that they bring and the services they provide to the institution (listen to the podcast interview at www.trusteemag.com)." Your hospital can't move forward without them.

Finally, "Meet the New Consumers" gives you a peek into the minds of patients age 30 and younger. Multitasking millennials run their lives with their smartphones, so if your hospital wants to serve them, its customer-facing technology had better be mobile-friendly. Valentine also advises beefing up social media to increase brand recognition. Generation Y should know your name before they need care.

Feeling energized? Good. Your community is counting on you.