While the more hotly contested health care reform issues, such as the public option and immigrant access to coverage, have garnered the most attention over the past few months, one particular aspect of health care reform has gone relatively unnoticed: the proposed transformation of the Medicare program through initiatives meant to increase quality of care, efficiency, and accountability while decreasing overall costs. Given the bipartisan support for these changes, they undoubtedly will appear in any final legislation, which means that Medicare providers and suppliers (collectively, “providers”) in all service settings should begin to understand these initiatives and consider their implications.