Myriad Health Alliance was established in 2018 and is a patient-centered conglomerate of healthcare systems across Mississippi that have joined to become members of a single organization where the patient and providers are true partners in care. Each member works together to better coordinate care with the goal of delivering seamless, high-quality care for the Medicare Fee-For-Service patients of Mississippi. Wholly owned by the participants (health systems), the infrastructure, governance, and MSSP requirements are centralized, but managed by the members through the ACO Board of Managers. Each community, which typically is comprised of a hospital and its affiliated physicians, has an equal share and voice in governance and has agreed to comply with the ACO processes related to the MSSP. A standardized approach to care coordination, patient engagement, promotion of evidence-based medicine, and quality reporting has been implemented in each community.