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Norwich — Before reviewing the past year’s performance at The William W. Backus Hospital and its parent, Hartford HealthCare, the network’s leader talked about the future.

With a photo of President-elect Donald Trump projected on the screen behind him, Elliot Joseph, chief executive officer of Hartford HealthCare, said there is “enormous” uncertainty about how health care will be affected by the election. Addressing the hospital’s annual meeting Wednesday, he said he nevertheless sees a bright spot on the horizon: the Trump transition team apparently is reaching out across the country for input about how the Affordable Care Act, which the president-elect has pledged to “repeal and replace,” should be changed.

“We’ve been invited to give input into what we would like to see happen with the Affordable Care Act,” Joseph said.

The request, he said, came over the weekend indirectly, from a colleague in Utah who heads a large health system and has contacts with the incoming administration. This health care executive was asked to identify other leaders in her field across the country, and Joseph was among them, he said.

“We’re excited that the transition team is reaching out to experts in the field for input,” he said. “We take that as a positive sign.”

In an email response, Joseph said, he listed six aspects of the Affordable Care Act he believes should be preserved:

• Coverage for young adults under age 26 on their parents’ policies

• Coverage for those with pre-existing medical conditions

• Allowing states that have expanded Medicaid coverage, including Connecticut, to keep that program

• Access to affordable coverage for the middle class, many of whom are “one health care bill away” from bankruptcy

• Tax credits for small businesses that provide coverage to employees

• Coverage for preventive care

“We asked that any changes be made slowly and thoughtfully, to give us time to adapt,” he said.

Despite the uncertainty about what will happen, Joseph said Hartford HealthCare and Backus are well positioned to weather whatever’s ahead. The network, which includes Hartford Hospital, Backus and Windham hospitals, provides care to one in four Connecticut residents, he said, and is continuing to expand across the state both geographically and in its scope of services.

Backus, with net revenue of $305.8 million for fiscal 2016, ended the year with a positive operating margin of 11.9 percent of revenues over expenses, down slightly from the 13.9 percent margin of fiscal 2015.

Among initiatives underway are the establishment of 10 urgent care centers around the state in partnership with GoHealth Urgent Care, adding the Zocdoc online scheduling service for medical appointments, greater use of telecommunications technology to connect doctors and patients, and the creation of six specialty centers in behavioral health, bone and joint care, cancer care, heart and vascular care, neuroscience and urology, Joseph said. Physician-in-chief doctors are being recruited for each of these areas, he said.

“Growing the market in Connecticut means we have to take market share from others, so we have to be better,” he said.

Bimal Patel, vice president of the eastern region of Hartford Healthcare and president of Backus, said the joining of Lawrence + Memorial Healthcare with Yale-New Haven Health means increased competition for Backus. But Backus and Hartford HealthCare, with an “A” bond rating and solid financial backbone, is positioned well to meet the challenge, he said.

Backus has expanded into the southeastern Connecticut shoreline with more primary care offices and an ambulatory surgery center, he said, and has been recognized in 2016 by the American College of Surgeons National Surgical Quality Improvement Program. It also was the only Connecticut hospital to receive four out of five stars for quality in the federal Centers for Medicare & Medicaid Service’s latest Overall Hospital Quality Star Rating, he said.

“We continue to push our boundaries,” he said.

j.benson@theday.com