This report from the National Academy for State Health Policy, funded by The Commonwealth Fund, describes how several states are driving their health care delivery systems towards more accountable care, with benchmarks for quality improvement and payment reforms based on health care outcomes and value. States that have promoted more accountable care include Colorado, Massachusetts, Minnesota, North Carolina, Oregon, Vermont, and Washington. These states have supported innovation in sharing health information and quality data, designing and promoting new payment methods, developing accountability measures, identifying and promoting systems of care, and supporting a continuum of care, including the patient-centered medical home.