In phase 1 of this project, McClellan and his team will: a) identify and engage potential implementation sites and stakeholders, including payers and regulators, in codeveloping a model for transferring international accountable care innovations to the U.S.; b) using a “client‐centered” approach, define the problems in the U.S. care delivery system that must be addressed; c) establish a network of experienced implementation partners, including the Institute for Healthcare Improvement (IHI); and d) define what success would look like. If this work proceeds satisfactorily, phase 2 support will be requested to undertake a global scan for effective approaches to caring for high‐need, high‐cost patients and payment mechanisms that drive better quality and lower costs. Phase 3 activities would center on analyzing and modeling of the impact of these innovations, while phase 4 would pilot a set of innovations in a U.S. health system or community.