Book excerpt: This book tells the story of the Baylor Scott & White Quality Alliance and its clinical network and payers who are committed to delivering accountable, value-based patient care. It describes the need for accountable care organizations (ACOs) in today's health care environment and details the framework and requirements needed to establish one. It provides readers with essential background information about accountable care. It includes examples from one of the largest accountable care organizations in the country as well as detailed outlines for developing an ACO.