This interim report constitutes the first milestone in the HCRCC’s development of a recommended blueprint for the state’s implementation of the mandates and opportunities presented by federal health care reform. It sets forth the following: 1) an overview of PPACA and its general implications for reform in Maryland; 2) the role and mission of the HCRCC; 3) the opportunities and challenges presented by reform implementation and the principles by which it must be guided; 4) the state’s unique health care landscape and regulatory environment against which implementation decisions must be made; 5) the projected fiscal impact of reform over the next decade; 6) the workgroup process through which the HCRCC will formulate its recommendations on the decisions most critical to our success; and 7) a timeline for planning and key activities. Along with multiple appendices that afford more detail and supporting documentation, this report provides a roadmap for the HCRCC’s work over the coming months. It seeks to set the stage for seizing our opportunity—and discharging our obligation—to create a better health care system for ourselves and future generations.