Hospitals and health systems increasingly must work with providers across the continuum of care to meet the demands of value-based purchasing, reduced reimbursements, new payment structures, and readmissions penalties. But replacing the current fragmented system of care will require nothing less than a business and clinical transformation. Healthcare executives say that care coordination and the care continuum represents their single greatest organizational challenge (HealthLeaders Media Industry Survey 2013, CEO Report). Executives and physicians must work closely on patient transitions, including a population approach to patient care, coordinated financial and clinical operations, and healthcare IT expenditures. Alignment—the sought-after state of agreement between hospitals and physicians—has never been more critical or challenging.