Although the Affordable Care Act may be best known for its mandates, insurance exchanges, Medicaid expansion, and guaranteed issue despite pre-existing conditions, its legacy may ultimately prove to be the creation of the Center for Medicare and Medicaid Innovations and the authorization of numerous demonstration projects designed to fundamentally change reimbursement from fee-for-service to fee-for-outcome. CMS has set an ambitious goal of shifting 50% of Medicare payments to “alternative payment models” by 2019. And at the heart of it all lies Health Information Technology. Innovations in predictive analytics, patient engagement, population health management, coordinated care, telehealth, interoperability, electronic medical records, and revenue cycle management hold the keys to this transformation. As investment capital pours into the space and providers seek to develop and integrate the technologies necessary to better align incentives in an extraordinarily complex health care delivery system, HIT is poised for a long and vibrant period of mergers and acquisitions.