After almost a week of covering the latest in cardiovascular news in the Windy City, it is time to reflect. At this years American College of Cardiovascular Administrators (ACCA) meeting, hospital thought leaders discussed what it takes to integrate the most innovative technologies and ways to incorporate the most cost-effective, quality-driven programs. This years American College of Cardiology (ACC) scientific session included clinical triumphs in anticoagulants and imaging techniques, among others, intertwined with the latest in research for a thought-provoking meeting. But both meetings left us asking one question, Where is healthcare headed?