If implemented successfully, accountable care organizations (ACOs) have the potential to achieve better care, better population health, and lower costs, according to a new report from the Commonwealth Fund Commission on a High Performance Health System. The report includes 10 recommendations to help ensure the success and spread of ACOs. In a Perspectives on Health Reform commentary, Commonwealth Fund researchers Mark Zezza and Stuart Guterman explore how the proposed rules for the new Medicare Shared Savings Program for ACOs align with the Commission's recommendations.