The Innovative Health Alliance of New York, LLC. (IHANY) is a collaboration among doctors, health systems and health care providers in New York’s Capital Region aimed at improving the health of the communities they serve by working together in new, more coordinated ways. In today’s evolving health care landscape, clinical integration is essential to achieving the three-part aim of better health for the community, better care for individuals and lower costs of health care. Health care reform, including where and how care will be delivered and how it will be paid for, is creating rapid transformation. Powerful market change presents both significant opportunity and significant risk. Health systems that will remain sustainable are likely those that have sufficient scale, size, scope, breadth, and quality outcomes to function in this new world of health reform. Successful models for the future will require integrated networks of physicians and hospital partners to manage these changes in health care delivery and payment. IHANY is the Capital Region’s first Clinically Integrated Network (CIN). This physician-led endeavor is designed to control health care costs and ensure patient care quality by enabling physicians, health systems, such as Ellis Medicine, St. Peter’s Health Partners, St. Mary’s Healthcare, Amsterdam, and other health care providers to work together in joint contracting and share incentive-based payments. The Innovative Health Alliance of New York, LLC (IHANY), is a collaboration that St. Peter’s Health Partners (SPHP) and Ellis Medicine (Ellis) began in 2014 that has grown to include a number of partners. This innovative business partnership is helping to organize and operate the Capital Region’s first Clinically Integrated Network (CIN) that will focus on access, quality, population health, and health costs. The new CIN will allow private physician groups, health care systems, and other health care providers to work together in coordinating and improving the delivery of health care, as well as participating in new methods of reimbursement.