This discussion paper from the RCHN Community Health Foundation connects the requirements for Centers for Medicare and Medicaid Services (CMS) incentive payments for the meaningful use of electronic health records, requirements for patient-centered medical homes, and the CMS proposed rule for Medicare accountable care organizations (ACOs). Especially given the proposed exclusion of community health center patients as assigned beneficiaries of the Medicare ACOs, the paper makes the case that community health centers should focus first on meeting the meaningful use requirements, and then on meeting the criteria for medical homes. Both these steps will be important, if not essential, platforms for community health centers to participate in ACOs.