This perspective details the concepts surrounding “accountability” in health care. The discussion begins with explanations of the loci, domains, and procedures of accountability. The authors explore different models of accountability and compare three to illustrate how these fit into the current health care climate. These include professional, economic, and political models, which, the authors argue, fail to serve an appropriate role in health care independent of each other. They propose a stratified model of accountability in which each serves a different purpose in the landscape between patient, provider, managed care, government, and professional association. The authors comment on the challenges with existing models of accountability and provide a detailed understanding of the interplay among them.