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Since its emergence more than two decades ago, participation in accountable care has become more established. In 2025, the Centers for Medicare & Medicaid Services (CMS) reported that more than half of Traditional Medicare beneficiaries are in an accountable care relationship. Considerable evidence indicates that patients benefit and costs are lower in coordinated, whole-person care models enabled by accountable care payment reforms. However, major barriers to participating in accountable care persist. It can be difficult to identify specific strategies that help providers and their patients engage and succeed in accountable care, and to find feasible policy revisions that support providers and patients. More rapid, practical learning is needed to identify what works and to help scale and diffuse care delivery strategies that increase accountable care adoption and performance.