Most US health care organizations have built their foundation on the financial incentives in fee-for-service (FFS) payment models. Changing their systems to respond to MACRA’s very different incentives will take time and is likely to pose challenges for many health care stakeholders. Top health care industry leaders recently gathered to discuss how best to implement the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This report contains the key takeaways and recommendations. It is a joint effort between the Deloitte Center for Health Solutions and the Network for Excellence in Health Innovation (NEHI).