The tremors you feel are not after-effects of this summer’s earthquake, but the healthcare landscape shifting beneath us to create better and more efficient care. Headlines highlight daily a high-stakes game of affiliations and mergers happening at a breakneck pace. New ways of providing care and paying providers are being tested. The Blue Cross Blue Shield of Massachusetts Alternative Quality Contract is no longer “alternative” as a majority of the Commonwealth’s providers are participating. As part of the Affordable Care Act, “Accountable Care Organizations” (“ACOs”) will launch nationally for Medicare beneficiaries in 2012.