Ladies and gentleman what I'm about to reveal in this article may be shocking to you, horrifying to some, and totally captivating to others. Regardless of your reaction, everyone involved in the healthcare transaction has to answer the questions for themselves. We can no longer afford to sit quietly on the sideline doing nothing, because at the present time the U.S. healthcare system is economically unsustainable and on the verge of collapse. Moreover, the Accountable Care Act (ACA) has begun to mutate the very DNA of how healthcare is delivered and reimbursed in this country. Our objective here is to inform and suggest a basic strategy to facilitate achievement of the triple aim. One thing we can all agree on is improved quality, increased satisfaction and reduced costs are generally good aspirations for our healthcare system.