Ever since the Centers for Medicare and Medicaid Services (CMS) released the Accountable Care Organization (ACO) final rule in October 2011, the American Society of Nephrology (ASN) ACO Task Force has been analyzing the rule to determine how it may affect patients with kidney disease and the nephrologists who care for them. This Q & A with Amy Williams, MD, and Emily Robinson, MD, is the first in a series of Q & A articles with task force members about ACOs and other approaches to new health care delivery models.