From Harpeth Consulting: This paper reviews the basic origins of accountable care organizations (ACOs) and outlines the key features of recent ACO initiatives including that of Centers for Medicare & Medicaid (CMS) pilot programs. While much of the current literature surrounding ACOs deals with the core competencies needed for a successful ACO, this paper aims to help organizations assess their readiness as well as provide a more tactical approach building on the existing research and academic thought.