The press was full of stories earlier this month about the Pioneer ACOs that would exit the program. Are we surprised? If my employer told me I could play a game that, at the end of the year, would give me either a 10% bonus or a 10% penalty, I might be down with that—until I earned a penalty. What incentive would I have to put money at risk the next year? The only incentive I would have would be the lessons I learned in the process of trying to earn the bonus if—and this is a big if—I knew that the new game ultimately would become the only game. Fortunately, HHS offers an ACO environment with protection from the downside, the Shared Savings program, and many of the organizations exiting the Pioneer program have elected to put on the training wheels and opt for Shared Savings. Lesson learned: You can't flick a switch and become an ACO. While Crystal Run narrowly missed the opportunity to assume risk as a Pioneer ACO, it was named a Shared Savings ACO, and Gregory Spencer generously shares lessons that organization learned in its ACO journey in this month’s issue. One of those lessons—and a key predictor of ACO success—was to leverage data to support the initiatives of leadership, and Cleveland Clinic is blazing a trail to enterprise business intelligence, also described in this issue. Lastly, I recently had the opportunity to hear Blue Cross Blue Shield Association CFO Robert Kolodgy’s perspective on health care reform. It was part actuarial assessment and part plea for a new spirit of cooperation between providers and payors in transforming health care—as nothing less than that will work. I invite you to visit the HealthCXO portal at www.healthcxo.com launched just a few months ago, where you will find many stories of health care innovation. Go forth and innovate!Cheryl Proval